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Tuberculosis: Glbbi 
Epoch Making In l^fedlclne' 


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"SMjP — ~^i:li£^- 

Original Articles. 


i;V HENEAGE GIBBES, M. D., C. M., L. R. C. P. 

Koch's statement concerning human and 
bovine tuberculosis, at the British Congress 
recently held in London, has caused a sen- 
sation throughout the world from which 
nothing but good can arise, inasmuch as 
numerous investigations will be made that 
will embrace all sides of the question ; and 
the statement of Professor Virchow, in re- 
gard to the German Commission (of which 
he is a member) that "henceforth the ana- 
tomical tubercle shall be fully considered," 
is most important. 

I should not be surprised if Koch has a 
still more startling statement to make pub- 
lic, for which that regarding human and 
bovine tuberculosis is a sort of pilot bal- 
loon. It must be remembered that he has 
never gone so far as some of his disciples, 
and that years ago he admitted having seen 
ises wherein no tubercle bacilli could be 

lund, a truism that has been abundantly 
Dufirmed by others; and yet there are 
many who still deny this well-proven fact. 
It is to be hoped that clinicians will now 
come to the front and let us have the result 
of their years of experience, gathered from 

careful painstaking observation of cases 
seen throughout their whole course. 

And here I wish to point out where I 
think the view that the tubercle bacillus is 
ever present, and a cause of all disease end- 
ing in destruction of the lung substances, 
has worked positive harm. We are famil- 
iar with the condition of the lungs when 
a consolidation is formed which, after a 
time, softens and breaks down, is thrown 
off, and a cavity left. This result, I con- 
tend, is brought about by two distinct dis- 
eases-processes, which should have en- 
tirely different treatment before this condi- 
tion is arrived at. 

The first is a purely inflammatory one, 
beginning as bronchitis, extending into the 
lungs as broncho-pneumonia, forming a 
consolidation varying in size according to 
the intensity of the inflammation and the 
number of bronchioles affected. Should 
the vitality of the patient be so low, or the 
intensity of the inflammatory process so 
great that the affected portion of the lung 
is unable to resist it, death of the part re- 
sults and then, after a time, a cavity is 

Careful study of a large number of these 
cases has proved that the disease-process is 
a purely inflammatory one from first to last ; 

Detroit, Mich., September 25th, 1901' 

Vol. 1, No. 6. 



and in cases of capillary bronchitis where 
death took place before the inflammatory 
process had extended into the lungs, the 
morbid changes were identical. Bacterio- 
logical examination of these cases fails to 
reveal the tubercle bacillus in the secretions 
of the bronchi, or in the consolidation in the 
lungs, until these organs begin to break 
down, and then they are generally present 
in large numbers. 

I am told by men who hold the general 
view that the tubercle bacilli are pathogno- 
monic, that these are cases of tuberculosis. 
I now desire to know when they became 
tubercular? From the number of cases ex- 
amined and the uniformity of the results 
obtained, I feel sure of the stage when the 
tubercle bacillus appeared on the scene. 
Was this the time when the broncho-pneu- 
monia became luberculosis, because this 
was when the disease-process had destroyed 
so much lung tissue that the patients would 
have, died anyway? 

I will venture to say that over fifty per 
cent, of cases with cavities in the kmgs are 
produced by broncho-pneumonia. Is it not 
then of the utmost importance that the num- 
ber of men who are trying to cure these 
pulmonary conditions should know which 
disease-process they are handling, since the 
same treatment can not apply equally to 
both ? 

The other form of lung disease resulting 
in the formation of a cavity is an entirely 
different disease-process. Take a typical 
case : Here we have a patient complaining of 
lassitude and fatigue easily induced; we 
notice a commencing stoop and rounding of 
the shoulders ; there may be no cough at 
this early stage, but a careful examination 
of the chest reveals dullness at one apex, 
generally the left. As we watch the case 
from day to day, it it is found the dullness 
is constantly extending below the clavicle, 
and thus, gradually, all the symptoms de- 
velop with which we are so familiar. There 
is no expectoration in the early stages ; there 

can not be as the bronchi are not affected 
and the consolidation has not yet broken 

This condition differs in loto from that 
first described : There is no acute inflam- 
matory process extending into the lungs, 
on the contrary the disease-process is going 
on in the lung itself; and this process con- 
sists of a new growth which, starting in 
one apex, gradually substitutes itself for 
the normal lung-tissues; as it grows new 
blood vessels are formed for its nourish- 
ment, and the growth slowly progresses 
until a large portion of the lung is involved ; 
the other lung becomes affected after a time, 
and we have all the signs and symptoms 
of pulmonary tuberculosis. This new tissue 
is of an unstable character, and in some 
manner cuts off the blood-supply from the 
central portion of the oldest tubercles, 
which becoine necrosed, then break down, 
and thus form cavities. 

I have made a long and careful study of 
these two disease-processes, which although 
entirely different, end in the formation of 
cavities in the lungs. — The accompanying 
illustrations, from micro-photographs, show 
the initial stage and full development of 
each form. 

The lower left-hand illustration is taken 
from a lung injected with Berlin blue, and 
the injected vessels are seen in the nodule; 
the whole is composed of cells, i. e., leucocy- 
tes, which have passed from the adjacent 
blood vessels by diapedesis in response to 
some irritation. This does not differ in any 
way from inflammatory exudation in any 
other organ or part of the body where sqj 
irritation exists, causing, immediately at 
spot, a massing of leucocytes, that is, infl£ 
mation, which increases until a consolida- 
tion is formed large enough to be recog- 
nized. At no period in this disease-proc( 
is there any new tissue formed. 

Taking the initial stage of this conditi^ 
as set forth in the left-upper illustrati 
we find a totally different process going 




there is no inflammatory exudation ; there 
is nothing acute about it, in the sense of an 
inflammatory re-action to an irritant. The 
first appearance of the lesion consists of one 
or more giant cells surrounded by a fibroid 
tissue, consisting- of fusiform cells arranged 
in a kind of network ; the giant cells vary 
-reatly in point of size, but all are multi- 
nucleated. When this small tubercle has 
grown to some extent, other small tubercles 
are formed in its periphery until the con- 
solidation reaches a considerable size ; at 
the same time it is only an aggregation* of 

We have, then, a portion of the lung 
that has become a mass of consolidation 
from the growth in it of an alien tissue 
which has entirely replaced that of the lung. 
This new tissue being of low vitality easily 
l)ecomes necrosed, breaks down and is 
thrown off, leaving a cavity. 

I have made a very large number of ex- 
aminations of both these initial stages and 
liave never been able to find the tubercle 
bacillus in either. Surely, if the tubercle 
1)acillus is the cause of either of these les- 
ions in the lung, it ought to be found at the 
commencement of the morbid process ! 
Contrasting this with leprosy : In the latter 
malady I have made many examinations of 
the liver, where the disease is never so far 
advanced as in other parts, and wherever 
there were two or three new cells formed 
from the connective tissue of the organ, 
there I invariably found the leprosy bacil- 

Here then are two disease processes 
that are absolutely different in everything 
but their results, viz., cavitation of the 
lungs. The two upper illustrations exhibit 
the adult conditions. 

I have already stated that tubercle 
bacilli are found in the inflammatory pro- 
cess after the lung breaks down. They 
are, in some instances, but not in all, 
found in a similar manner in the other 
process. Many cases are on record where 

no bacilli could be found during life, or 
even after death and, as far as I have 
been able to ascertain, these cases all be- 
long to the second of these disease-pro- 

It must be plain to any thinking physi- 
cian that these two conditions can not 
be approached and treated in the same 
manner, and I .think that it is of the ut- 
most importance that the difference 
should be recognized at once on examin- 
ing a case. I saw this well exemplified 
recently, when called in consultation to 
a child twelve years of age : A small 
consolidation existed on one side, about 
the level of the third rib ; dullness was 
well marked, but moist rales were found 
round the edge ; auscultation and percus- 
sion above the consolidation showed that 
the lung was performing its functions 
and that the consolidation did not ex- 
tend to the apex. This at once removed 
any idea of the case being one of tubercu- 
losis, but, on the other hand, showed it to 
be a patch of broncho-pneumonia, clearing 
up; and subsequent events proved this 
opinion to be correct. 

I wish to point out that this new tissue 
which is formed in the lungs under the 
influence of the tubercular virus, differs 
entirely from that produced as a re- 
action to a chronic irritation ; this is well 
shown by Doctor W. F. Metcalf, in his 
paper on "Pseudo-Tuberculosis," publish- 
ed in the May number of this Journal: 
There he shows that the prolonged irri- 
tation produced by the presence of the 
chitinous chelicerse of an Ixode in the 
cutis vera, caused the formation of a 
nodule, the cells of which were entirely 
unlike any of the normal cells of the 
part; but these cells were also quite dif- 
ferent from those of a tubercle such as 
I have described. 

Pfeifer has lately described a pseudo- 
tuberculosis and Klein has confirmed his 
results ; their deductions seem rather 
contradictory, but further work on this 



subject may have an important bearing 
on tuberculosis. One thing seems cer- 
tain : Many workers will now take up 
the pathological side of the question, 
when there will be a great deal of light 
thrown on these conditions; and I very 
much fear the child-like faith of the bac- 
teriologists will be rudely disturbed. 
92 Edmund Place, 

Detroit, Michigan. 



At a meeting of the British Pathological 
Society, of London, April 6th, 1875, the 
"Germ Theory" of disease was first formally 
introduced, the discussions being very ani- 
mated and earnest, — which also obtained 
at subsequent meetings. This conference 
was attended by distinguished medical men, 
some of whom were profoundly impressed 
by the arguments brought forward. The 
co-existence of bacteria and contagious dis- 
ease was admitted, but Doctor Bastian, one 
of the most prominent speakers, contended 
that they are pathological products spon- 
taneously generated in the body after it has 
been rendered diseased by real contagion. 
The grouping of the ultimate particles of 
matter to form living organisms, was con- 
sidered, by the speaker, to be an operation 
as little requiring the action of antecedent 
life, as their grouping to form any of the 
less complex chemical compounds. 

Prior to this, Henle (in 1840) after ma- 
ture deliberation, collating and weighing of 
evidence, had arrived at the conclusion 
that the causes of infectious maladies are 
to be found in minute living organisms or 
fungi ; hence he may be regarded as the 
true and original author of the "Germ 
Theory." — He formulated opinions and in- 
vestigated the subject with such thorough- 
ness and ability that, in after years, Koch 
adopted precisely the same views. In 1862, 
Pasteur published a paper on the "Organ- 

♦Annual Oration, Michigan State Medical 
Society, Battle Creek, May, 1901. 

ized Corpuscle existing in the Atmosphere," 
in which was demonstrated that many of 
the floating particles are organized bod- 
ies, and that these, when planted in 
sterile infusions, yield abundant crops of 
micro-organisms, evidencing that the source 
of life in the infusions was derived from the 
air. Listerism originated in 1875, and when 
Koch published his famous work on the 
Wundinfectionskrankheiten (traumatic in- 
fectious diseases), three years later, the 
Listerian theory took firm root, spreading 
slo'wly but surely to all departments of 
medicine and surgery. 

From time to time, as the need was real- 
ized, men of genius have provided devices 
and instruments with a view to aiding in this 
work, and some of these have made pos- 
sible subsequent discoveries. — Among these 
may be mentioned the use of sterilized cul- 
ture fluids as formulated by Pasteur; the 
introduction of solid culture media and the 
isolation methods of Koch; the use of the 
cotton plug by Schroeder and Van Dusch; 
the introduction of the anilin dyes by Weig- 
ert and, finally; the improvements made in 
the compound microscope. 

It is interesting to note that after the 
discovery of the anthrax bacillus by PoUen- 
der and Davaine, in 1849, there was a pro- 
longed period, during which no important 
discoveries of pathological organisms were 
made, but during this period important 
methods of technique were elaborated. This 
was again followed by a period during 
which important additions followed each 
other in rapid succession: In 1873, Ober- 
meier discovered the spirillum that bears 
his name and is deemed the source of re- 
lapsing fever; Hansen, in 1879, announced 
the discovery of a bacillus in the cells of 
leperous nodules; and Neisser during the 
same year demonstrated tlie gonococcus; 
in 1880 the typhoid bacillus was first ob- 
served by Eberth, and subsequently and in- 
dependently by Koch ; the same year Past- 
eur published his work on "Chicken -chol- 
era," and the pneumococcus was descrilx'l 




by Sternhcr- ; in 1882. Koch announced 
the Bacillus luhrrciilosis. \vhich was soon 
followed hy rasleur's work on "Rouget 
du Pore," while Loeffler and Schiitz 
reported the isolation of the bacillus of 
glanders; in 1884 the "comma bacillus" was 
announced by Koch as the probable source 
of cholera, about the same time Loeffler 
discovered the germ bearing his name con- 
jointly with that of Klebs, and believed to 
be that of diphtheria, and before the end 
of the year the tetanus bacillus was demon- 
strated by Nicolaier; in 1892 Canon and 
Pfeififer announced the bacillus of influ- 
enza ; in 1894, Yersin and Kitasato inde- 
pendently isolated the germ of the bubonic 
])lague, and Sanarelli discovered the Bacil- 
lus ictcroidcs, supposed to be the source of 
yellow fever. 

During the last quarter of a century the 
science of bacteriology has made triumph- 
ant strides, revolutionizing all preconceived 
ideas and theories respecting the aetiology, 
diagnosis and even the treatment of infec- 
tious diseases ; among those upon which in- 
formation has been of greatest value are, 
tuberculosis, diphtheria, tetanus, bubonic 
plague, etc. 

Up to 1875 there were few scientific men 
who accepted the germ theory, the great 
majority adhering to the doctrine of spon- 
taneous generation, believing, with Billroth, 
that the presence of fungi, where decom- 
position was in progress, was an accidental 
result of universal distribution or (more 
conservatively) that their presence in pu- 
tpid wounds was either due to spontaneous 
development or accidental and artificial in- 

McFarlane was among the first of any 
promiri'.nce to accept the germ theory as 
applied to diphtheria : He says that all pos- 
siljle skepticism as to the specificity of bacil- 
li was dispelled by an accidental infection 
that confined him to the house for three 
weeks during the busiest season of the 
>ear. A\'ithout having been exposed to 
any known contagion, and while experi- 

menting in the laboratory with a virulent 
culture, the diphtheria l)acilhis was drawn 
into a pipette and accidenially entered his 
throat. As the result of this accident, two 
days later his throat was full of typical 
pseudo-membrane which contained Klebs- 
Loeffler bacilli. 

Welsh, of Johns Hopkins, has perhaps 
furnished the most reliable as well as the 
most complete statistics of the results ac- 
complished by the antitoxin treatment of 
diphtheria : Excluding every possible error 
of calculation, his report shows an apparent 
reduction of 55.8 per cent, in mortality. 
Another very important point made by this 
author illustrates the importance of early 
treatment, viz. : The fatality in 1,115 cases of 
diphtheria, treated in the first three days 
of the disease, was about 8.5 per cent., as 
against 546 cases injected with antitoxin 
after the third day, with a death rate of 27.8 
per cent. — Thus was established the fact 
that early treatment is essential, and that 
after the toxin has set up destructive or- 
ganic lesions in the various organs of the 
body, no amount of neutralization will re- 
store the integrity of the parts ; consequent- 
ly, antitoxin fails to be of material benefit 
in the latter class of cases. 

In 1884, Lusgarten devised a methcnl for 
staining bacilli found in syphilitic tissue, 
which germs he assumed to be the cause of 
the disease. The most recent research on 
bacterium of syphilis is that of Van Xies- 
sen, w^ho claims to have cultivated from the 
blood of a few cases, and by inoculation 
experiments obtained evidences of the speci- 
ficity of the organism, by the production of 
abortion in pregnant rabbits ; by the de- 
velopment of extra-genital primary lesions 
on the ears of the same in the form of 
nodes ; and by the production of secondary 
ulcers, tumor-formations and irregular 
lesions. However the researches of others, 
up to the present time, have not been satis- 
factorily confirmative, and consequently the 
specificity of this germ is not established. 

Considering our increased possessions in 



the Far East, the importance of early rec- 
ognition of the bubonic plague can be ap- 
preciated, especially when the United States 
Marine Hospital Service reports the intro- 
duction of this fell malady to the Western 
Hemisphere. Its appearance in Santos, 
Brazil, in October, 1899, marks an epoch in 
plague literature, as furnishing the very 
first recorded instance of the disease in the 
New World. During November of the 
same year the malady was brought to New 
York by a British steam-ship, and late in 
December, 1899, it made its appearance in 
Honolulu; its advent in California is so 
recent, that mere mention is sufficient. 

This disease furnishes a striking illus- 
tration of the scientific advance of mod- 
ern medicine, for it was not until 1894 
that its true nature became positively 
known. All through the centuries, in 
all the countries, the subject had been 
enveloped in darkness, and there was a 
blind groping after facts, an unsuccess- 
ful search for cause, and the same igno- 
rant struggle against its ravages, on the 
~ part of physicians, sanitarians and pub- 
lic officials alike, such as obtains to the 
history of cholera, a malady that now, 
fortunately, by the efiforts of science, is 
robbed of its terrors. So, too, the cause 
of the plague, the mode of propagation 
and the measures essential to prevent its 
spread, are to-day matters of general 
scientific information. To Pasteur and 
Koch is indirectly due the credit of this 
discovery by establishing bacteriology 
as a science, though to a Japanese physi- 
cian, Kitasato, and the French observer, 
Yersin, we are indebted for the discov- 
ery itself. The fact is now established 
that the plague is an infectious malady 
caused by a specific bacillus; and the 
anti-pest serum of Yersin and Roux, and 
the Haf^kine prophylactic, have been 
tested with most gratifying results, the 
latter for the prevention of the plague, 
the former for its effects upon the bu- 
bonic poison whereby it is neutralized 


within the system. The French Com- 
mission that recently investigated the 
efficacy of the anti-pest serum in Portu- 
gal, report that the mortality was but 
fourteen per cent, against seventy per 
cent, of fatalities where the serum was 
not employed. 

In a recent lecture by Roux, a striking 
illustration was given of the efficacy of 
the Yersin serum: 

The Bombay manager of the local branch of 
the Credit Lyonnaise resided with his wife, 
children, and a numerous retinue of native ser- 
vants, in a dwelling in an infected portion of 
the city. His little daughter was stricken 
with the pest in a virulent form; was treated 
with the serum and made a rapid and unevent- 
ful recovery. As a precautionary measure the 
whole family were subjected to inoculation and 
the same measure of treatment was oiTered to 
the native domestics. Those who accepted es- 
caped infection, while all of the six who declin- 
ed were striken, five fatally. It seems that a 
more crucial test could not have been devised 
or a more triumphant vindication obtained. 

The British Medical Journal gives the 
results accruing to the employment of 
Hafifkine prophylactic in Bombay, which 
show a reduction in mortality of eighty 
to ninety per cent. 

The work of the late Federal Commis- 
sion in establishing the disputed fact that 
the plague existed in California, was a 
signal triumph for science and marks an 
epoch worthy of a place in the archives 
of modern achievement. 

In 1896, Widal and Griinbaum, working 
independently, discovered that when blood- 
serum from typhoid fever patients is added 
to cultures of the typhoid bacillus, a definite 
reactive phenomenon occurs; this is known 
as the "Widal reaction," and consists in 
complete cessation of the characteristic 
movement, and subsequent agglutination, 
of the typhoid bacilli. The test was applied 
to two hundred and thirty cases of typhoid, 
among troops engaged in the Spanish-Am- 
erican War, treated in the Medico-Chir- 
urgical Hospital, and of this number two 
hundred and nineteen reacted positively, or 
95.64 per cent. The statistics derived from 
Osier's wards in the Johns Hopkins Hos- 
pital, by Block and Gwyn, up to November, 



1898, evidence that the reaction was present 
gin one hundred forty-four of a total of one 
lundred fifty-one cases. Statistics further 
ieveloped the fact that the reaction failed 
in only 4.5 per cent of cases out of a total 
\pi 2,393 ; ^"d ^t is probable that even this 
small percentage would have been further 
reduced if the test, when negative at the 
irst examination, had been repeated every 
[day or two until convalescence was fully es- 
ttablished. Without granting the precision 
lof the method, it nevertheless may be as- 
[sumed to be of great diagnostic importance. 
Bacteriology is the outgrowth of the med- 
icine and surgery of the past; and from 
[being looked upon as nierely incidental 
Ithereto it has become the dictator of the 
medicine of the present and future. Much 
valuable work has been done on the acute 
and chronic inflammatory diseases, also on 
the toxemias and bactericides. 

Hematology, a comparatively new study, 
has become an adjunct to clinical diagnosis, 
but sufficient time not having supervened, 
the limits of its usefulness have not been 
fully determined; the evidences afforded, 
thus far, have been very disappointing some- 
times — results accruing that were wholly 
unexpected, perhaps opposed to those 
sought, — while again, on the other hand, 
shedding far more light than could have 
been anticipated. The number of mala- 
dies in which its value is apparent are 
less than a half-score, but that it proves 
a decided aid in many more is not to be 
gainsaid ; it may provide the missing link 
in a chain of otherwise incomplete evi- 
dence. On the whole, hsematology in its 
results is not inferior to examination of 
urine ; both give definite results in a few 
diseases, and side lights in many obscure 
conditions, even if the process itself is 
negative ; and the former has one very 
decided advantage : It can be employed 
during the life of the patient, and like 
all methods of purely physical character, 
in all febrile maladies, and where there 
is any cause (such as insanity, stupidity 

or unconsciousness) preventing intelli- 
gent communication with patient, much 
light can thereby be obtained. 

It is now conceded that Anopheles, a 
form of mosquito, may convey the para- 
site of malaria from man to man ; even 
a resume of the literature of the subject 
would consume so much time and space, I 
must, per force, be content with mentioning 
that, important observations by original 
workers are now being made in the trop- 
ics that promise more practical informa- 

The most striking feature in this con- 
nection, however, is the (apparently) defi- 
nite establishment that the cause of yel- 
low fever is present in the blood of those 
attacked thereby, and that certain mos- 
quitoes can inoculate healthy individuals; 
also that the disease is not transferrable 
by fomites. This is regarded as a very 
important medical discovery, removing in 
large part the mystery obtaining to the 
aetiology of a malady that is, not alone 
the scourge of some of the fairest portions 
of the globe, but renders certain districts 
thereof prac-tically uninhabitable to civil- 
ized man. 

Relative to the cause of cancer. Max 
Schuller, of Berlin, and Roswell Park, of 
Buffalo, (and the co-laborators of the lat- 
ter at the State Hospital), have accomp- 
lished some excellent work ; Park reports 
having been able, in some of the lower 
animals, to produce true adeno-carcino- 
nias by inoculation with fluid from the 
peritoneal cavity of a man suffering with 
colloid cancer of the omentum. Schul- 
ler reports* having found in both carcin- 
oma and sarcoma a golden-yellow body, a 
protozoon, that he presumes to be the 
primary cause of these growths ; and a 
culture thereof, when injected into a rab- 
bit, produced cancerous tumors, while 
other cultures revealed the organism in 
different stages of development. The re- 
sults of experiments now in progress, are 

*Centralblatt fuer Bakteriologie, 1900. 



awaited, both in Europe and America, witli 
great interest. 

Since the discovery of the Roentgen 
rays, great advances have been made in 
the practical appHcation of this myster- 
ious form of energy. Somewhat reckless 
predictions, born of enthusiasm, have 
been indulged in, nevertheless they have 
proved of great diagnostic and therapeu- 
• tic value, and time may be expected to 
establish more fully their scope and util- 
ity. At one time it was seriously feared 
that the prolonged exposure, deemed es- 
sential to successful observations, would 
limit their usefulness, but the improve- 
ments in technique that have recently ac- 
crued, permit of excellent results being 
secured with more brief exposures. Now% 
with our improved methods, a diagnosis 
is often possible, and with a precision that 
can not be obtained in any other way. By 
means of the radiograph, foci of tubercular 
infection can be made manifest to the eye 
much earlier than to the ear; a unilateral 
or bi-lateral enlargement of the heart, or 
any form of cardiac displacement, is read- 
ily discovered by the same means; em- 
physema, asthma, pleurisy, hydro-pneu- 
mothorax, pyo-pneumothorax, hydrothorax 
and pneumonia, are easily recognized 
and their limits defined; thoracic aneu- 
rysms are recognizaI-)le in their early 
stages; cavities which escaped detection 
by ausculation or percussion are revealed; 
and the presence of fluid within the 
pleura may be positively determined. Senn 
declared the X-rays as employed during 
the late war, "fully answered all expecta- 
tions," and added: ■ 

During the Spanish-American War the skia- 
graph enabled us to diagnose the existence or 
absence of fracture in a large number of doubt- 
ful cases in which we had to depend exclusive- 
ly on this diagnostic resource. In fractures in 
close proximities to joints, it has been of the 
greatest value in ascertaining whether or not 
the gun-shot fracture extended into the joint. 
In the light of recent experience the X-ray has 
become an indispensable diagnostic resource to 
the military surgeon in active practice, and the 
suggestion that every chief surgeon of every 
Army Corps should be supplied with a portable 

apparatus, and an expert to use it, must be con- 
sidered a timely and urgent one. 

Manifestly the limit of usefulness of this 
aid has not yet been determined. It may be 
noted, however, that the rays have rendered 
valuable aid in tlie treatment of diseases of 
the skin, more especially lupus vulgaris, lup- 
us erythematosus, chronic eczema, vas- 
cular naevi, hyper-trichosis, favus, and 
sycosis ; also in other pathological condi- 
tions of internal organs. 

During the past ten years, phenomenal 
advancement has been made in the diag- 
nosis and treatment of diseases of the 
stomach ; the cyromele has been invent- 
ed ; the gastro-diaphane perfected ; a per- 
fect gastric electrode introduced, likewise 
the gastric bucket ; X-ray pictures of 
stomach have been taken ; a large number 
of lavage apparatus devised ; the gastro- 
scope made fairly practicable ; and a 
number of operative procedures devised. 

In considering the burning questions 
of the day it is ^-equisite to include the 
bacterial toxins, sero-therapy, organo- 
therapy, auto-intoxication, and the rela- 
tions of internal secretions to problems 
connected with the nervous system, — 
that part of the human organism which, 
in the main, is responsible for the lofty 
position which man holds among ani- 
mals. The last decade has given birth 
to unprecedented activity in connection 
with the progress in neurology. The re- 
sults obtained have led to complete revo- 
lution in ideas concerning the elements 
of the nervous organs and their mechani- 
cal relations, and supplied a host of new 
methods of investigation in the prosecu- 
tion of the study of the nervous system 
in health and disease. Entirely new ave- 
nues of research have been opened up, 
and problems heretofore thought beyonrl 
the reach of scientific inquiry seem now 
within human grasp. So numerous haw 
been the methods of original research 
pursued, that space and time forbid their 
review; I shall merely mention briefly 



a few of the main achievements : Among 
the names which have shed new lustre 
on the subject of neurology is that of 
Ramon y Cajal, whose connection with 
original work has been both brilliant and 
fruitful. If popular history can be relied 
upon, the story of this young scion of 
Spain is remarkable, especially from a 
medical standpoint: Developing in a 
country not remarkable for original re- 
search, he applied for a position as teach- 
er of the microscope, and was refused; 
whereat, being ambitious, industrious 
and proud he was keenly wounded. He 
then purchased a small library devoted 
to histology and microscopy, practically 
ostracised himself from society, and be- 
gan his original work, paying special 
attention to technique, and as a result found 
himself, a decade later, famous. A brief in- 
quiry into the contributions of Cajal can not 
fail to reveal why, since 1888— and in all 
parts of the scientific world, — his produc- 
tions have attracted attention, and ultimate- 
ly gained for him a professorship at Madrid, 
as well as notice and appreciation by in- 
ternational audiences. Among his origi- 
nal contributions are: "Demonstration 
of the Complete Independence of at least 
the Majority of Nerve Elements" : "Ap- 
preciation of the Wide-spread Occur- 
rence and Significance of the Lateral 
Branches of the Axis-Cylinder Process- 
es," and : "Demonstration of the Strik- 
ing Uniformity in General Structure of 
the Majority of Nerve Elements in all 
parts. Despite Minor Morphological Ele- 

Since 1880, investigations of Golgi, His, 
Kolliker, Cajal and others, have produced 
a complete revolution in ideas relative to 
the elements of which the nervous sys- 
tem is constructed, and also of the mode 
in which these elements are architectur- 
ally put together. The Golgi method of 
staining tissue is now recognized by the 
whole scientific world, and the pictures 
of nerve cells and their processes secured 

thereby (incomparably superior to any- 
thing hitherto obtained) are regarded 
in the light of a new discovery. Cajal 
with his incomparable genius made new 
applications of the Golgi method, which 
have attracted wide-spread attention, and 
anatomists everywhere (von Kolliker 
and others in Germany, van Gehuchten 
in Belgium, Retzius in Sweden, Schafer 
and Andriezzen in Great Britain, Berkeley 
and Strong in America, and a host of 
others) set to work with the osmo- 
bichromate mixture and silver nitrate, 
and in a short time a new era was opened 
up, and information supplied regarding- 
the reciprocal relations of nerve units in 
the various parts of the cerebro-spinal 
and sympathetic nervous systems. The 
connection of the axis-cylinder processes 
of the cells of the neutral horns with the 
axis-cylinder of the fibres of the motor 
roots of the spinal nerves, were first ab- 
solutely established by Weigert's meth- 
ods coupled with the method of Gerloch. 
— This, in conjunction with improved 
technique in sectioning, has contributed 
greatly towards the investigations in 

In 1891, Waldeyer brought out the 
doctrine of individuality of the nerve ele- 
ments, or the "Neuron Concept," which 
may be briefly condensed as follows : 

The nervous system, aside from its 
neurolgia, ependymal cells, blood vessels 
and lymphatics, consists of an enormous 
number of individual elements of neurons, 
each neuron in its entirety representing a 
single body or cell. The foundation for the 
neuron doctrine rests upon these facts: 

The nervous system agrees with other 
parts of the body in being cellular: 

The proof that in the embryo the nerve 
cells exist as independent units, many of 
which are capable of wandering for con- 
siderable distance from the origin : 

The fact that the nutrition of the nerve 
cells is most easily explained from the stand- 
point of a doctrine which looks upon the 
nervous system as made up of units, which 
are not only anatomical but physiological. 

Since this doctrine was advocated a 



large amount of work upon degeneration 
of nerve-fibre and cells has been done, 
especially by Marchi, which confirms the 
validity of the neuron doctrine, the latter 
being of value in enabling the histologist 
to follow the diseased nerve-fibre to its 
termination. The conception of the neu- 
ron has helped to facilitate the under- 
standing of some diseases, in showing 
that there is no cardinal distinction be- 
tween gray and white matter ; and it like- 
wise served to unravel, in part at least, 
the mystery which formerly surrounded 
those diseases that involve, almost sim- 
ultaneously, the various systems of white 
fibres and the gray matter. Proportion- 
ately with the growth of the neuron con- 
cept the value of systemic diseases is 

Do what we may, we can not separate 
mental diseases from organic affections of 
the spinal cord and, indeed, of many other 
organs of the body. The line of demarca- 
tion between the mental and physical con- 
ditions is so indistinct that, in many in- 
stances, one merges into the other. One of 
the foremost alienists of Europe latterly de- 
clared that psychiatry is on a level with the 
medical sciences of a hundred years ago, 
being based wholly upon clinical studies 
and not upon pathological anatomy. A few 
years since. Doctor Weir Mitchell, during 
his annual address to the American Medico- 
Psychological Association, indulged in se- 
vere criticism upon the lack of scientific 
work in hospitals for the insane, which 
aroused no trifling indignation. That 
abundant material for scientific work 
exists, both clinical and pathological, is 
undeniable, and that there has been 
marked advance, both in the character of 
the clinical work and in honest endeavor 
along setiological lines, is conceded. That 
greater advancement has not been made 
can not be attributed wholly to inertia on 
the part of those in charge, but is largely 
due (especially in relation to causation) to 
the well known fact that the morbid path- 

ology of the brain is more complex than any 
other part of the human organism. The 
asylum reports instead of being given over 
to stereotyped data, as formerly was the 
case, to-day are fast becoming store-housi. 
of useful information regarding all that per- 
tains to the care, cause, and treatment of 
the insane. To the practical psychiatrist the 
question of domiciliation does not over- 
shadow every other desideratum, as in the 
past, and during the last decade the im- 
portance of early diagnosis, the accompany- 
ing pathological conditions, prompt separa- 
tion from domestic surroundings, and skill- 
ful treatment (mental, moral and physical) 
have become questions of paramount in- 
terest. Closely trained observers, records 
of clinical facts, also systematic laborator 
work, are now the rule rather than the ex 
ception in many institutions : Pleasant, 
cheerful rooms have taken the place of dark- 
ened cells ; airy courts are provided, along 
with beautiful grounds and attractive archi- 
tecture ; the Kirkbride system has replaced 
the old quadrangular buildings, and the 
cottage pavilion, in some form, is fast super- 
seding all others ; finally, the specially train- 
ed, and skilled nurse has been substituted 
for the ignorant (and sometimes careless) 

The work of Meynert on the cerebral 
cortex, and the researches and experimental 
labors of Charcot, Flechsig, Wernicke, et 
al, have done much to illumine conditions 
hitherto obscure and considered impervious ; 
the labors of the New York Pathological 
Institute, under the leadership of van 
Gieson, have received the recognition and 
commendation of many of the original in- 
vestigators of Europe as well as Amer- 
ica, and the original contributions of 
Berkeley to the pathology of brain l es- 
ions, have stimulated the study of p^Hj 
chiatry in insane hospitals everywheflS 
It is the spirit and honest endeavor on the 
part of those interested in the science of 
psychiatry (together with the increase of 
insanity over and above the increase in 




population) which makes possible a psy- 
chopathic hospital in Michigan in connec- 
tion with institutions of learning, exactly as 
such are now established in connection with 
the older universities of Europe. At the 
present time there is no branch of medical 
science which offers so many interesting 
problems for solution ; and though the past 
has been full of disappointments, the future 
is full of hope. 

We begin a new century under most en- 
couraging auspices. That just closed will 
go down into history as one marvellous in 
scientific achievement, especially in many 
departments of medicine and surgery, and 
as marking the close of the career of dog- 
matic medicine ; but there are still many im- 
portant subjects that require careful and 
profound consideration. Fortunately, sci- 
ence recognizes no nationality; from Ger- 
many, Belgium, Sweden, Russia, Italy, 
I'Vance, Spain, Japan, South America, 
England, Canada and the United States, 
come reports of work that embody the 
spirit of scientific research to an eminent 
degree. What of the future? That more 
brilliant achievements are soon to follow, 
few can doubt. Serum therapy is yet in its 
infancy, and although one of the crown- 
ing triumphs of the Nineteenth Century, 
there are certainly great possibilities as 
regards its future scope and employment. 

35 Bagley Ave., 
Detroit, Mich. 




December 2d. — The weather has been un- 
usually tempestuous for the last week or 
so, and high winds and frequent showers of 
rain have been the rule, so that, though the 
anchor was once hoisted to go outside for 
target practice, we returned the same day 
without doing anything. Fortunately the 
inside anchorage is so protected by a reef, 
that there is never any sea no matter how 
higli the wind, and there are never any hur- 

ricanes here. Our ship is anchored very 
close to the shore, that is to the reef — nbt 
the landing in the town, — and like all craft 
in the harbor that desire it, we have a tele- 
phone while in port. The reef is the in- 
evitable coral formation found generally 
throughout the Pacific, and with its crest- 
line of white breakers, dividing the apple- 
green or amethyst shoals from the blue of 
the ocean, under a bright afternoon sun 
only now and then obscured by a swift 
passing cloud bringing with it a spoonful of 
rain, is beautiful with a beauty unequalled. 

Yesterday I went ashore, and there being 
less wind and rain than usual, made an- 
other trip out the Nuuanu road. On the 
way up I observed a sight that was very 
amusing: A white house with large, well- 
kept grounds, numerous trees, shrubber>- 
and flowers, presented quite a menagerie. 
If of nervous disposition, one is apt to be 
alarmed by seeing a full sized lion, ap- 
parently stalking across the grass toward 
him, with only a low fence intervening and 
offering protection. The animal's eyes are 
large and the whites very prominent, which 
give him an expression of mingled pain and 
ferocity that becomes ludicrous when it is 
discovered the creature is of cast metal._ 
There are at least half dozen of these form- 
idable brutes,- all loose, without even collar 
or chain, standing in the rank grass with- 
out a pedestal or platform for their poor 
feet, and their bronze or cast iron fur is 
quite mouldy with damp. These are not the 
only sham animals on the premises ; there 
is at least one deer, the most wildly impos- 
sible quadruped imaginable; also certain 
white statues of young women, presumably 
marble, but which I suspect are after all but 
ordinary cast iron, whitewashed. The lions 
are full grown, and rather much for one's 
nerves, inasmuch as they are artfully ar- 
ranged, apparently lurking in the recesses 
of the shrubbery, yet visible to the wary 
traveller, and besides very white eyes, are 
well toothed in deeply lurid jaws. 

I paused half way up the Nuuanu road, 
mauka side (that is seaward side) to take 
in the view, upon which I have expatiated 
before. I may as well say, right here, that 
mauka is a word of great resource among 
the natives, and in this instance means the 
side furthest away from Honolulu. 

I have before spoken of the little spring 
a few hundred yards down the cliff towards 
the valley beyond the pali; also that both 



men and women here ride boldly. While 
lingering at the spring I heard a clatter, 
and up came a cavalcade of some sixty or 
seventy ponies and mules, all with little 
packs on their backs, driven by Chinamen, 
who all dismounted at the top of the pali, 
which natives would never have thought 
of doing. These islands are a perfect 
paradise to the Celestials, and they travel 
about a great deal ; and although cutting 
most awkward figures, they can ride, or at 
least stick on, or do anything else necessary 
to their business ; and they go fast and 
slow according to the needs of the time or 
place with the same stolid indifference they 
show in the laundry. They frequently in- 
termarry with the natives, and the type re- 
sulting is rather peculiar and not unpleas- 
ing. The remarkable thing about the Ce- 
lestial is his ability to adapt himself, in his 
peculiar way, to anything and everything, 
^consequently he is found in every form of 
business where money is to be made. Some- 
how there always seems to me something 
strange and almost uncanny about these 
guttural jabbering people, though why, I 
cannot say. 

The walk up and down the Nuuanu road 
was more interesting than it would other- 
wise have been on account of the great num- 
ber of roadside flowers and weeds which, 
though seldom of any size, were so plentiful 
as to give decided color Cm patches), to the 
landscape. A purple flower of the mint 
family was about the only one that re- 
minded me of our vegetation at home, ex- 
cept some convolvuli -which were every- 
where apparent. There was also a very 
bright yellow fluffy ball of a species of 
mimosa ; a pure blue but very delicate 
flower like a forget-me-not ; and variegated 
clusters of a blossom which I thought I 
ought to know but could not place — all so 
thick as to make the outer edges of the road, 
and banks of the ditches and taro-patches 
bear resemblance to the borders of a flower 
garden, and withal it must be remembered 
this is in mid-winter. I think there is rather 
a large variety of plants indigenous to 
these islands, but hundreds more have been 
introduced as ornaments, or for utility, 
from all parts of the world. The other day 
Mrs. Afong (of whom more anon) gave me 
a blossom of the ylang-ylang from a tree 
in her garden, the odor of which was won- 
derfully penetrating. All classes of Hawa- 
iians, as well as the South Sea Islanders, 
are passionately fond of flowers and bright 

colors, especially red ; even the cannibals 
of the Solomon Islands have this taste. 

Walking into town on my way back I 
observed many fine places, though perhaps 
not very carefully kept, but with plenty of 
trees, royal palms, date palms, algarobas, 
bread-fruit, etc. The Afongs possess a 
noble banyan, the only one I know of in 
the city ; and cocoa-nuts are only too com- 

December 5th. — The weather here can 
hardly be fancied for this time of year. It 
is not really hot, neither is it always cool 
or comfortable ; though bright this morning, 
in -the afternoon it turned out showery, as is 
usual at this season. In the main, blue uni- 
forms are more suitable than the white ones. 
The rain, however, has brought out a 
wealth of flowers, especially roses, very 
fine ones being visible on every hand. 

I just broke off to bum a piece of cam- 
phor on account of the mosquitoes that ap- 
pear unusually ravenous and blood-thirsty — 
this procedure, which has the sanction of 
"authority," never proves very efficacious. 
On shore the Chinese have curious orna- 
mental furnaces, made from some sort of 
white metal, in which they burn a powder, 
sometimes of sandalwood, sometimes Pyrc- 
thum rosiim, better known perhaps under 
its pseudonym of "Persian Insect Powder;" 
the art of the thing is, that the powder is 
poured over a little iron mould, which is 
then withdrawn leaving the contents di- 
vided into continuous ridges, so that when 
a match is touched to one end the fire creeps 
and smoulders along evolving smoke for a 
couple of hours or so — if the powder was 
simply piled up it would all be consumed 
at once. 

Off Lahaina, December loth. — We ar- 
rived her yesterday for target practice and 
are bound for Hilo, on the island of Hawaii. 
The ship is under weigh, with her great 
guns going, and while I am writing, every 
now and then, if one of the after battery 
is fired, my ink-stand fairly jumps from the; 
table. • i 

I presume there will be no opportunity 
to visit the shore here, hence my descrip- 
tion is merely of what can be seen from the 
deck or from a port. There is a strip of 
low green land, apparently level and fringed, 
with cocoa-nut trees, just inside the shore- 
reef. The slopes beyond, and towards thej 
mountain ridges that form the background, 
are green with sugar-cane and other crops; 
then there are rifts or deep ravines intersect- 



ing the ridge ; and finally a pali that appears 
inaccessible. From the ship — we are twelve 
or fifteen miles oflf Maui — we can see the 
islands of Molokai, Lani, Kahoolawe and 
Hawaii, including the famous extinct vol- 
cano of Haleakala, with the largest crater 
known, which rises on our port beam nearly 
1 1, GOO feet, and so huge as to appear dome- 
shaped. This volcano is separated from the 
Lahaina district by a low sandy ridge. As 
we coast along, with the aid of glasses I am 
able to detect quite a number of little sec- 
ondary craters that rise out of the bulk of 
the mountain ; and I am told there are scores 
of cones within the main crater, which is 
twenty-eight miles in circumference. One 
very perfect cone appears to rise from the 
sea-bottom, as it is entirely surrounded by 
water. It is a long time since this volcano 
has exhibited evidences of activity, and on 
the last occasion its force appears to have 
been exerted from northwest to southeast 
and all along the chain from Kauai to 

Hilo, December 27th. — This is a most en- 
chanting little settlement half hidden be- 
neath a wealth of flowers and a forest of 
bananas, bread-fruit and cofifee trees, with 
here and there thick clusters of cocoa-nuts 
shooting high in air waving their leaves 
and rattling trunks in a very indolent and 
graceful style peculiarly their own. Then 
the deep, velvety verdure around gradually 
rises in green slopes and recedes far away 
in the distance, until the scene is closed by 
the "twin giants of the Pacific," Mauna 
Kea and Mauna Loa. Nearer, along the 
shore, are silvery rills leaping into the sea; 
and the bay is constantly alive with canoes 
and boats, with their broad paddles flash- 
ing in the sun, each holding two or more 
chattering, gesticulating natives, offering 
for sale tempting tropical fruits reposing 
dewily in leafy baskets. 

Neither is the town disappointing on 
closer view. The richest and most dense 
of tropical foliage shades and almost ob- 
structs the pathways ; pretty huts of thatch- 
ed straw, cottages, and even more preten- 
tious dwellings are embowered in groves 
and shrubbery, while flowers abound in pro- 
fusion on every hand ; streams of limpid 
water murmur in every direction, and the 
cool trade-winds blow breezily through the 
foilage — alltogether the effect is most Arca- 
dian and quite exhilarating. Then, always 
when we go ashore, there are la'rge numbers 
of copper-hued natives, rigged out in the 

gayest colors, waiting to receive us, includ- 
ing a stout individual with a most import- 
ant air, and a crown embroidered on the 
sleeve of his coat which, along with a short 
baton, conveys the information he is a 
Kaiko or "king's man," in other words an 
authorized guardian of the peace. 

On Sunday I happened in front of the 
native church just as the congregation — 
something like eight or nine hundred peo- 
ple — was coming out. There were ancient 
matrons in dazzling print frocks, cut very 
high in the neck and very low at the heels, 
but unconfined by either belt or bodice, each 
with one or more pieces of ancient millinery 
appertaining to a long forgotten era, gaud- 
ily decorated and perched high upon their 
sinciputs and conveying the idea they had 
been put on wrong end foremost, — as was 
the actual fact in many instances; young 
damsels attired in gaily colored shawls and 
ribbands, their nether limbs encased in a 
superabundance of hose and strong brogan 
shoes ; venerable, gentlemanly Kanakas in 
tightly fitting trousers and swallow-tail- 
ed coats unconscionably short in the waist, 
and ditto long in the skirts, while others 
were only saved from appearing in pur is 
naturalihus by a flimsy shirt, or fold of 
tappa wound about the loins, breech-clout 

Hawaii, or properly, Owyhee, affords a 
fair glimpse of primitive island life, being 
less visited than other portions of the 
group ; but the natives have, apparently, 
lost little by this fact. They still preserve, 
in some degree, their old habits and heathen- 
ish customs, and many deep-rooted and im- 
moral practices still obtain. Nevertheless, 
it strikes a stranger with surprise to find 
these demi-barbarians can all read and 
write, and that the well-defined caligraphy 
of the Hilo nymphs will compare favorably 
with that of the most fashionable style of 
the art in young ladies' seminaries and 
"finishing schools" at home; they also pay 
strict observance to the "Sabbath" (out- 
wardly at least), have a general, even 
though slip-shod, knowledge of the Scrip- 
tures, and many possess a tolerable educa- 
tion. The natives, moreover, are amiable, 
good natured, though indolent beings, and 
approach nearer to the toxijours gai than 
any people in existence ; nevertheless, let 
no one imagine from their simplicity of 
manners, he can win their hearts wath gim- 
crack jewelry, glass beads, and baubles of 
that ilk ! Peradventure he will discover 



they have as correct an appreciation of 
silver, and can drive as sharp a bargain as 
ever the Jew out of Jerusalem. Still they 
are obliging and will attend you all day 
in tramps and excursions, apparently well 
satisfied with a trifling present of cigar- 

Among the favorite dishes is that of 
raw fish, and as a great rarity a hian 
dog. Under the most solemn pledges of 
secrecy, I was permitted to witness the 
exhuming of one of these animals, with 
the privilege of dining therefrom in case, 
he was fovmd palatable. These solecisms 
on modern cookery and viands are severe- 
ly frowned upon by their white teachers 
and pastors, consequently it was with 
much caution I was taken to a small hut 
in the outskirts, where, when a venerable 
Kanaka had been placed on guard to pre- 
vent surprise from Kaikos, the entertain- 
ment began. First, a huge calabash was 
pla^ced on the ground filled with the Na- 
tional preparation of poi-poi — a white 
mixture made of mashed and fermented 
taro, of the consistency of paste and a 
flavor of sour starch; and it is not con- 
sidered the mode to eat it with aught else 
but the fingers — one, two, three, or the 
whole hand, according to its liquidity. The 
Hawaiians beat the Neapolitan lazzaroni in 
dextrous use of their digits and digestions, 
for whereas the latter can only suck down 
several continuous leagues of macaroni 
without a bite, and be satisfied, the Kanaka 
will make a cone of hand and fingers, and 
• with the whirling velocity of a water-spout, 
takes up enough of the plaster-of-Paris-like 
liquid to make a thorough cast of mouth 
and jaws, with the energy to repeat the im- 
pression every minute! No wonder the 
natives, for most part, are pot-bellied! 
Where all the stuff goes too is a mystery. 
It has been suggested that they are hol- 
low, like bamboos, down to their heels ; but 
it is a mooted point. I tasted the poi-poi by 
way of an appetizer, and felt no further 
indication to make a hearty meal, especially 
as I knew it had all been chewed at least 
once in the making, and the fact the opera- 
tion is generally performed by white tooth- 
ed maidens, and that success depends upon 
the thorough admixture of saliva, did not 
tend to render the dish any more palatable. 
By the time the poi-poi had disappeared, 
the stones and leaves were taken from a 
sunken oven in the corner of the hut ex- 

posing the bouf-zvow to view. The warn- 
ing of cave canem which I had seen in 
former years at Pompeii never struck me 
forcibly till now ! I had heard, too, a meta- 
phor to the effect that the "hair of a dog 
is good for the bite," but the moment I 
beheld the entire animal with his white jaws 
and tongue lolling, I felt no indication for 
even the bite — lost my appetite and came 
quickly away, with the intention of turn- 
ing informer, and sending the Kaikos in 
among the party. 

While dealing with Hawaiian cuisine I 
may as well speak of some other matters 
pertaining thereto : The manner of fatten- 
ing these interesting and delicate animals 
is not dissimilar to the process of cram- 
ming turkeys with walnuts, or geese pre- 
paratory to having their livers turned into 
pate de fois gras. These animals are of a 
peculiar kind — short-legged and domestic. 
The feeder takes a mouthful of poi-poi, and 
after masticating it to proper consistency 
and shape, seizes his victim by the throat, 
chokes the jaws wide open, and drops the 
contents of his own oral-cavity into that 
of the brute — it is said violence is only 
necessary with puppies, for on becoming 
older and docile they take to this diet more 
kindly. I have twice partaken of liiart 
turkey — fattened by the same process, and 
considered by the natives as only inferior 
to luau dog, — but it proved on both oc- 
casions to be a most insipid dish. The gob- 
bler is stripped of his plumes, cleaned, 
dressed, stuffed with a green cabbage-look- 
ing vegetable known as Inaii (hence the 
peculiar title), carefully swathed like a 
mummy in damp banana leaves, and laid on 
a native oven of red hot stones, all covered 
thickly over with more leaves until not a 
chink or cranny is left for the escape of 
heat or steam. How long the bird is com- 
pelled to undergo this operation, I do not 
exactly remember, but on sitting down to 
the table, he was ushered in on a huge 
platter in his green winding-sheets, and 
after removing the outer coatings presented 
a whitish par-boiled appearance, half- 
drowned in a pulpy mass of liiaii, and fell 
to pieces at the first touch ; he was steamed 
to death. There was not a trace of turkey 
flavor left, and I thought it the worst pos- 
sible use he could have been put to ; albeit 
the vegetable was delicious and in the main 
made amends for tasteless fowl. 



-Detroit Hedical Journal 




Publishers, Booksellers and Importers. 

Note.— The management cannot undertake to return rejected 
manuscript unless sufficient postage is provided to cover the 
expense thereof. 

Address all communications, of whatever nature, at 270 
Woodward Avenue, Detroit. Michigan. U. S. A. 



We stop the press to announce this de- 
plorable and sorrowful event which, though 
sudden, was not altogether unexpected by 
medical men who had carefully followed 
the results accruing to the assassin's bullet. 

"In multiple counsel there is safety" is 
an ancient and threadbare aphorism that, 
however true in its application to ordinary 
affairs, in conditions like those surrounding 
the bedside of the martyred Chief-Execu- 
tive is apt to prove delusive. We have no 
wish or purpose to criticise adversely the 
medical gentlemen in attendance; admitted- 
ly each, individually, is a man more than 
ordinarily professionally endowed, and pos- 
sessed of considerable more than a mere 
local reputation ; but on the other hand we 
c^n not but feel the sufferer and his medical 
advisors alike were sadly handicapped by 
the results accruing to popular clamour, and 
the demand that no measures, however ex- 
traordinary, be left undone — such generally 
results in overdoing, especially when the 
patient is possessed of great prominence, 
and the facts are taken into consideration 
that, amid a multitude of counsel, clashes of 
opinion are possible, and no medical man, 
except one possessed of unusually strong 
personality, would, in the face of the ad- 
verse opinions of colleagues, (and the cer- 
tainty of mis judgment on the part of the 
public and professional press), dare to act 
in any way independently, or to overstep 
in any particular the boundaries of accus- 

tomed routine. We certainly would have 
had more hope, from the first, if the Presi- 
dent had been relegated to the exclusive 
care of one or two individuals. 

Also, we can not but deprecate the un- 
seemly attempts to secure advertising for 
self and friends on the part of individuals, 
which led to the importation of an alien 
nurse, and (at the last moment, when the 
fatal termination had become inevitable) 
of physicians from far away cities ; both 
acts appear to reflect upon the ability of 
those in attendance, and particularly upon 
nurses and medical fraternity of Buffalo. 

Again, the excluding of Mrs. McKinley 
from her husband's bedside, and the denial 
of the accustomed cigar — which was crav- 
ed, and asked for, and could have work- 
ed no possible harm, while it might have 
obviated certain adverse phenomena — 
smack of the torture-chamber and mediae- 
val superstition more than anything else : 
— Does not one suppose, if Mrs. McKinley 
is the woman we take her to be, that these 
procedures had her sanction, though ex- 
clusion was made to appear solely in her 
interest ! Here we have two factors that, 
seemingly, in the minds of most, of little 
importance, may have had direct influ- 
in securing the untoward result. "Noth- 
ing is more depressing to an invalid than 
an enforced quiet without any form of 
physical or mental occupation, especially 
when surrounded by strange attendants. 
Apparently, not only was Mrs. McKinley 
very carefully excluded, but her spouse 
was left to the "rule-of-thumb" care of 
an alien "trained" attendant. 

We learn the immediate cause of death 
was "gangrene of both walls of the 
stomach and pancreas." It seems passing 
strange, in the face of previous reports 
(emanating apparently from authority) 
that such condition could have existed 
without being suspected; the character 
of the pulse, to say the least, was such as 
to lead to a surmise that some untoward 
event w^as threatening. 



One of the theories propounded is, that 
the bullet of the assassin, with a devilish- 
ness almost unprecedented in modern 
times, was deliberately poisoned, for the 
purpose of making the fate of the victim 
doubly certain. This, however, seems high- 
ly improbable. 

Undoubtedly, there yet remain many 
facts to be made public that are of inter- 
est to the medical profession, and accord- 
ingly we await the official and authorita- 
tive report. Such data as are at hand, com- 
ing as they do through the Associated Press 
and filtered through the hands of non- 
professional editors, are altogether mea- 
gre and unsatisfactory. 

The political lessons of the tragedy are 
many; it is hoped they will be taken full 
advantage of as regards the future. It is 
possible that the "grief of the Nation may 
ultimately prove the Nation's salvation" 
in the matter of eradicating the anarchistic 
and other obnoxious socialistic elements. 

Fortunately the executive chair will 
now be succeeded to by a gentleman pos- 
sessed of no less great personality than 
Mr. McKinley, one moreover whom the 
breath of scandal has not been able to 
touch, and whose high rectitude and hon- 
esty of purpose is unchallengeable. 

Cajuput Oil. 

The advent of oil of Melaleuca Leuca- 
dendron dates back to 171 5 when it was in- 
troduced to Europe via Amsterdam. An 
apothecary very properly was responsible 
for the introduction, but it appears to have 
languished a century after this before Lon 
don took it seriously under consideration. 
During the cholera epidemic of 1830 it came 
into wide repute, which has since been 
sustained, more or less, as a valuable dif- 
fusible stimulant, antispasmodic and dia- 
phoretic. Unfortunately, owing to its high 
price, oil of cajuput {Oleum W ittnehianum) 
is subject to adulteration, and the vast mst- 
jority of that offered in the market is 

nothing but a mixture of turpentine, oil o( 
rosemary, camphor and bruised cardamor 
seeds, treated with a little milfoil to giv< 
the requisite color. Oils of camphor, lavi 
ender, origanum and rosemary frequently 
serve for adulteration. 

The true oil, when taken internallyJ 
causes a sensation of warmth in the stom-i 
ach. excites the action of the heart anc 
arterial system, and subsequently inducesi 
copious diaphoresis. 

In gout and rheumatism much benefit 
follows both the internal and external use 
of this agent ; in retrocedent gout it is par- 
ticularly serviceable in doses of from live 
to six drops, frequently repeated. It is 
occasionally of great service, employed both 
internally and externally, in neuralgic af- 
fections, but is inadmissible if the malady 
is connected with inflammatory conditions. 

Immediate relief attends its exhibition in 
flatulence and flatulent colic, maladies in 
which it has never been known to fail. In 
typhoid and other low forms of fever it 
may be judiciously prescribed as a stimu- 
lant ; so too, as an antispasmodic, it proves 
valuable in convulsions attended by debility 
or anaemia. 

It has been recommended in epilepsy, but 
its value is somewhat problematical except 
when the disease is associated with hysteria 
or with great nervous depression ; but in 
hysteria, even in considerable doses it ap- 
pears to be inferior in action to either asa- 
foetida or valerian. 

In spasmodic cholera the oil has been 
highly lauded, and in some instances its ac- 
tion has appeared to be almost magical ; on 
the other hand it has frequently failed to 
be of any real benefit, which possibly may 
be due to the fact that an impure product 
was employed. 

All in all, cajuput oil is a remedy of 
great power and value, one too much neg- 
lected in general practice ; but it is demand- 
ed when this drug is employed that its pur- 
ity be definitely assured. 



Two Novel Claims. 

In the Medical Record for July 13th., ap- 
pears two novel communications which, 
undoubtedly, will attract considerable at- 
tention : 

One, on the "Etiology of Alopecia," by 
Doctor Delos L. Parker, of Detroit, ad- 
vances the theory that this malady is due to 
auto-intoxication through absorption of de- 
composed organic matter present in the 
residual air of the lungs, and upon which 
the author bestows the title Trichotoxicon. 
Experiments upon pigeons, that were in- 
oculated with a solution of respired air in 
water, seems to confirm the claim, but lack 
satisfactory negative and control evidence. 
This is a very interesting communication, 
whatever the verdict of the profession may 

The second is the claim of one Doctor 
H. Holbrook Curtis, that he immunizes 
hay-fever sufferers by administering a prep- 
aration purporting to be made from the 
pollen of certain plants, more particularly 
^'ragweed" {Ambrosia triUda), golden-rod 
(Solidago odora), etc. What is more re- 
markable is the fact that this paper, though 
read before the American Laryngological, 
Rhinological and Otological Society, prior 
to its appearance in the Record had been 
distributed broadcast as a part of the ad- 
vertising literature of a well known phar- 
maceutical house ; also the unsigned "tes- 
timonials" read very like those that obtain 
to patent medicine almanacs. Hence it 
is a matter of considerable surprise to us 
that this paper obtained place in a publica- 
tion of the standing of the Record. The 
"ear-marks" to say the least, are those of a 
proprietary product, and the text affords 
no ])ositive or conclusive information as 
to the character of the compound, while the 
title, is manifestly intended to be "catchy." 
We opine the concern that has under- 
taken to market this preparation, will find 
it has committed a grievous error, particu- 
larly as it has hitherto been held to be im- 
maculate in the matter of foisting upon the 
profession products of doubtful character. 

Fighting the Nile Sudd. 

The difficulties and dangers of tearing 
a passage through the dense masses of 
floating vegetation which periodically ob- 
struct the Nile, making navigation im- 
possible, are well described in an article 
which appears in the August number of 
Pearson's Magazine. A free waterway has 
now has been opened up the river as far 
as Uganda. In all fourteen blocks of the 
sudd, as the drifting marshes are called, 
have been removed, the total length of the 
river cleared being eighty-three miles. The 
actual work was done by some 750 .Soudanese 
prisoners under the direct orders of two 
young officers of the British Royal Navy. 
The following is an extract from a journal 
kept by one of them : 

Now, as to how we do it. On arriving at a 
block we tie up the steamer, and set every- 
thing on fire, then cut down all the dead 
papyrus, which is on the sudd, until it soon 
looks like a very rough field. Then this field is 
dug into small sections four or five yards 
square; the trenches are dug to about two feet 
under water, the sudd itself being one, two, 
or three feet above water, and from six to ten 
underneath. Next we put pieces of wood round 
our section (cut up telegraph poles), fix a wire 
hawser round- the section, shoved well down in 
the trenches and behind the posts, and bring 
the two ends on the steamer. The steamer 
then backs astern, and eventually pulls out the 
section, which fioats away down-stream. The 
wire is got on board again, the poles are re- 
covered, and the steamer proceeds for another 
section. The force anl jerk which the steamer 
brings on the wire severs the roots of the sec- 
tion underneath from the others — or at least 
something does! That's the idea. 

It is expected this work will have a ma- 
terial bearing on the fevers, especially those 
of malarious character, peculiar to the up- 
per Nile region. 


Epilepsy and the Bromides. — 

The bromides, unfortunately, have been 
widely heralded as specifics for epilepsy; 
yet no claim can be farther from the truth. 
They may temporarily suppress epileptic 
attacks, but only during the period in which 
they are exhibited to the point of saturation ; 
they are in no sense remedial. 

Again, a great deal of the trouble ac- 



cruing to the administration of this class of 
agents is due to the selection of a poor and 
cheap salt. Bromides of potassium, of am- 
monium, of lithium, etc., are unpalatable 
and in the main unsatisfactory, the stomach 
quickly rebelling against their administra- 
tion. If one must have a bromide, select 
one that will not upset the stomach and in- 
terfere with digestion and assimilation. 
The sodium salt is the only one that fulfills 
this demand ; if dissolved in water it affords 
a fairly palatable, even refreshing drauglrt ; 
it may, moreover, be employed for a long 
time, in maximum doses, without any un- 
toward results and carries with it a larger 
percentage of bromine than most other salts. 

Epithelioma. — 

A writer in the Chicago Medical Times, 
asserts as the result of "forty years ex- 
perience" that extirpation by the knife is 
much less efficacious than the employment 
of a paste of zinc chloride — "for some rea- 
son the same amount of tissue sacrificed 
by the knife will give far better results if 
destroyed with the caustic ; with the former 
recurrence is the rule, by the latter, the ex- 
ception." The claim is likewise made that 
"chloride of zinc has as great efficacy and 
is as certain death to cancer cells as is 
quinine to malaria." — The latter part of 
this quotation is certainly a trifle foggy. 

How about lactic acid which is practically 
harmless to healthy tissue, but inimical to 
the adventitious or neoplastic form? The 
latter has been successfully employed to 
destroy growths that recurred within three 
weeks after expiration, and at the cicatrix. 

Oleum Jecoris Aselli. — 

Doctor Jones Greer of Newport, Eng- 
land,* takes exception to this authorized and 
official synonym of cod-liver oil. He re- 
marks : 

"Asellus signifies a little or young ass. This 
word has also been extended to fishes, as the 
cod {Morrhua vulgaris), which have the color 
of the ass; at least, Varro, in speaking of 

fishes named from their color, mentions the 
asellus, or cod, as deriving its name from this 
circumstance. Those therefore who trust to 
a dictionary might not be able to tell whether 
oleum jecoris aselli meant the oil of a cod's 
liver or the oil of the liver of an ass. In 1839 
the latter translation was actually adopted by 
a writer in a medical journal, who gravely told 
his readers that the Germans had been using 
oil of asses' livers for fifteen years!" 

Doctor Greer's quotation, derived from 
a foot note on "Lac Asellae" in Selecta e 
Prcscriptis, is interesting as exhibiting the 
uncertainties of philological derivation. 

Preservation of Anatomical Specimens. — 

Pathological specimens are best preserved by 
the aid of formalin, which has the effect of re- 
taining the natural colors of the preparation. 
Judging from the specimens shown, the result, 
so far as preservation of color is concerned, is 
everything that can be desired. The process 
requires both patience and experience to ob- 
tain the best results, but its introduction marks 
a new era in the preservation of museum speci- 
mens, the decoloration of which, under the 
methods hitherto resorted to, constitues such a 
serious drawback to their educational value. . 

— Medical Press and Circular. 
Equally as valuable, and perhaps even 
more effective, is a mixture of methyl 
alcohol, sulphurous acid and glycerin, equal 
parts. Morbid specimens placed in this 
fluid, after proper preparation and cleans- 
ing, may be kept almost indefinitely without 
either shrinkage or loss of color. 

Brucine for Children. — 

It seems not to be known that for patients 
under ten years of age brucine is a much 
better, and every way more effective stim- 
ulant (though milder) than strychnine. 

A solution of brucine, newly made, more- 
over, is a very satisfactory topical analgesic : 
the "earaches" of children may often be ef- 
fectually relieved by inserting in the audi- 
tory meatus a pledget of cotton saturated 
with this fluid. 

*The Lancet, London. 


For the relief of coryzas vegetable char- 
coal is suggested by Doctor T. M. Stewart, 
of Cincinnati. He states the remedy is par- 
ticularly indicated if there is irritation of 
the trachea and bronchi with mucous expec- 
toration, chilliness and light colored urine. 



Jystitis and Urethritis. — 

One of the most valuable agents for the 
relief of either of both these conditions is 
corn silk, and to secure its best effect the 
ledicament should be exhibited in the form 
)f an infusion made from the freshly gath- 
ered drug, and newly prepared every couple 
|days or so. When the Stigmata niaydis is 
)ut of season, a "German tincture" will do 
^ery well from which to make the infusion. 
The dose should not be less than one 
irachm, and gradually pushed to one ounce, 
[or a half wine-glassful. That this drug is 
|a valuable adjunct in the management of 
ronorrhoeic cases is self evident. 

of the medicaments recommended for the 
topical treatment of this malady are ef- 

[Leucorrhcea and American Women. — 
Not only do our women have leucorrhcea 

[to an unprecedented extent, but they suffer 
from many other forms of disease of the 

^sexual apparatus, more than women of 
other countries. Certainly something is 
wrong to produce this condition so univer- 
sally, and one can not but believe our social 
laws need radical revision. The corset is 
accused of being the chief factor, but this 
is doubtful, for French women, even more 
than Americans, are addicted to the mon- 
strosity, which has survived, in some form, 
several centuries. The artificial conditions 
of life ; the improper foods commonly in- 
gested ; habits that inhibit proper tissue toni- 
city ; and the freedom with which the sexes 
commingle, even at a very early age, are 
undoubtedly more at fault than any article 
of feminine apparel. 

Gonorrhoea. — 

The latest fad in the treatment of this 
form of the venereal is a solution of zinc 
acetate and albumen naphtho-sulphonate. 
It is however, no way superior to dozens 
of other remedies possessed of astringent 
and aseptic tonic properties^ and vastly in- 
ferior to the hot-water douche. The error 
universally made, is neglect to order the 
patient to bed, and" keep him there until 
cured ! If this rule is followed almost any 

Chinese Yeast. — 

The substance known as Chinese or Jav- 
anese yeast is largely used in Eastern Asia 
for the fermentation of rice. This fungus, 
which has the power of exciting fermenta- 
tion, has been made the type of an inde- 
pedent genus, Amylomyces ; but Wehmer, 
in The Pharmaceutical Journal and Tran- 
sactions, shows it is a true Mucor, and 
hence gives it the specific title of M. rouxii. 
It ferments levulose, dextrose, galactose, 
sucrose, lactose, maltose, and inulin, with 
the production of alcohol. It is accom- 
panied by another undescribed species of 
Mucor, which also takes part in the fer- 
mentation of "ragi," and is named M. jav- 

Alopecia. — 

For some years the item has gone the 
rounds that pilocarpine was an effective 
remedy for alopecia. The fact is, however, 
it has never' been observed to have any ef- 
fect upon the disorder, whether adminis- 
tered internally or applied topically. 

Each case .of alopecia demands to be 
studied by itself and prescribed for accord- 
ing to its nature. Disinfecting and stimu- 
lating remedies are most in demand, yet it 
must be acknowledged that our therapeutics 
are for the most part powerless, and that 
the rare cures which result are not so much 
due to medication as to spontaneity. 

Diabetes Mellitus, Potatoes in. — 

It has long been a moot question as to 
whether potatoes may have a place in the 
dietary of diabetics. Recently this has been 
decided by Mosse*, at least to his own satis- 
faction : He declares the tubers may be 
given to the amount of two to three pounds 
daily, and as a substitute for the whole 
(or part) of the bread allowed, and that 

*Klinische Therapeutische Wochenschrift. 



the cases which respond best to such man- 
agement are those of medium intensity and 
of the arthritic type. Two cases are cited in 
evidence of the wisdom of this decision in 
which "there was prompt decrease in the 
amount of sugar excreted in the urine." 

Milk, Artificial Coloring In. — 

A simple method to detect artificial tint- 
ing of milk, is to precipitate the coloring 
matter on fibre. If anatto, for instance, is 
suspected, render the sample of milk alka- 
line with sodium bicarbonate and then partly 
immerse it in a strip of white filtering 
paper, allowing to remain several hours, 
— x^natto imparts to the immersed paper 
a yellow tint. The same method may be 
employed to detect methyl-orange, except- 
ing that ammonium carbonate must sub- 
stitute the sodium salt, and clean white (ab- 
sorbent) wool employed instead of paper. 

Curangine. — 

This alkaloid, according to Boorsma, is 
possessed of marked febrifuge properties 
and derived from Curanga amara, a mem- 
ber of the family Scrophularacce, having 
the formula a8Hi7O20. it is easily soluble 
in ethylic and methylic alcohols, aqueous 
acetone, and acetic ether ; less so in ether, 
petroleum ether, carbon disulphide ; and but 
partly soluble in chloroform and pure acet- 
tone. In water it is soluble to the ex- 
tent of 6.18 per cent. 

Important if True. — 

The Dominion Medical Monthly declares 
that "Pressure over the supra-orbital foram- 
en in alcoholic coma will cause a man to 
come to immediately," and that this method 
may be employed to diflferentiate between 
alcoholic coma, diabetic coma, hysterical 
coma and apoplexy. 

We should like to have this statement 
more fully verified, especially as it is not 
an editorial utterance. 

Will not some of our readers, when the 
opportunity oflfers, experiment and report? 

Tuberculosis. — 

An exchange declares that this disease 
is very common among pets — dogs, cats 
and parrots. 

This is in a measure true, as parrots and 
monkeys are specially prone thereto, proba- 
bly because they are kept in too confined 
space without a proper supply of fresh air. 

The great trouble with pets is, that the 
average woman insists upon keeping them 
too warm, particularly if their natural 
habitat is the tropics or sub-tropics, under 
the supposition that equatorial regions 
yield a uniform heat. One of the most 
delicate of the Simian tribe, that escaped 
from its master, was known to have sur- 
vived for several years in a mountain forest 
in northern Georgia, where ice in midwinter 
is no uncommon feature; and presumably 
it would have lived much longer but for the 
interference of the man with a gun. 

Scanty Menstruation. — 

Aside from the ordinary domestic reme- 
dies and the employment of apiol (true) 
and cannabis Indica, there is probably no 
agent superior to black cohosh, which should 
be administered in doses of fifteen to thirty 
minims at least four or six times daily. It 
is most eflfective with women living quiet 
sedentary lives, and that are closely ap- 
proaching the menopause. 

Use of Laryngoscope. — 

Drop a minim of glycerin upon the mir- 
ror, warm slightly over an alcohol flame, 
then wipe oflf quickly. This will prevent 
the blurring of the image from condensation 
of respiratory vapors. 

Heart Maladies. — 

Potassium iodide is a valuable remedy 
where fatty degeneration exists as the re- 
sult of debility or overwork; it is equally 
effective in both true and false angina. 

But Most People Do. — 

It is folly to expect the stomach to do the 
work of the teeth. 



Items and News. 

An Ascetic's Lament. — 

Audi, doctor, me clamantem, 
Trista voce lamentantem ! 
Aqua horrida interna 
Ventris plena est cavernal 
Diaphragma, in thoracem 
Aquae vi Impressum, pacem 
Rapit jam pulmoni, omnes 
Fere noctes sunt insomnes, 
Nunquam autem tulit venter 
Mens aquam-phy! libenter! 
Ergo doctor fac me salvum, 
Aqua liberando alvum, 
Ne sis Fabius Cuncator, 
Veni Medicus Punctator. 

— Deutsche Medisinal Zeitung. 

The Tuberculin Cattle Test.— It has 

been declared that "if anything has been 
demonstrated to a mathematical cer- 
tainty in experimental pathological medi- 
cine and anatomy, it is the fact that tu- 
berculin is a sure test of masked or, un- 
recognized tuberculosis in cattle." 

This is the dogmatic, assertive side of 
the question. Practically, it is found the 
British Royal Commission on Tubercu- 
losis, after a lengthy, careful and pains- 
taking investigation, reported that the 
tuberculin test on cattle was untrust- 

There are some people in this world 
who would continue to assert that night 
was day if they stumbled at every step 
for want of light. — Lawrence. 

The Practitioner and His Finances. — 

The man who neglects to secure his 
financial position by careful investments, 
insurance, and prompt collection of bills, 
may arrive at the age when he ought to 
cease active practice, and yet be obliged 
to continue to make his daily living. Too 
often keen, able practitioners develop 
into querulous, jealous, disappointed old 
men, because they are obliged to compete 
with the younger men when they ought 
to have retired with honors. — Medical 

The Photo-Bacterium. — 

Pure cultures of the photo-bacterium — 
which is the cause of the phosphorescence 
of the sea, — can be obtained by placing a 
fresh haddock, or herring, in a two per cent. 
salt solution and keeping it at about seven 
degrees above freezing. In a few days the 

fish and all the fluid give off a pale greenish 
light, made more brilliant by adding a little 
sugar. The cultures can even be photo- 
graphed by their own light. — The Lancet 


Ozone, Uses of. — 

This agent is coming into use for many 
purposes. While it artificially ages liquor, 
and spirits generally, it improves coffee, 
and is of advantage in the treatment of 
tobacco, of which it improves the aroma. 
It seasons wood for sounding-boards of 
musical instruments, and also has the ef- 
fect of protecting it from the ravages of 
moisture and temperature. It is used for 
thickening oil in the manufacture of lino- 
leum, and its action in bleaching linen is 
familiar to most of us. — Western Drug- 

The Country Physician. — 

While there is much truth in the state- 
ment that, "Where there is nothing great 
to be done, a great man is impossible" — 
when it comes to medicine^ to be a modest 
country doctor, surrounded by a confiding 
constituency, is no mean position to oc- 
cupy, and might well fill the cup of ambi- 
tion for the best equipped man. — Clinical 

Night Work. — 

This is a much exaggerated evil of the 
physician's life. In the first few years of 
city practice there is not a superabundance 
of either day or night calls, and to one who 
falls asleep full .of apprehensions as to the 
success of the future, the jingle of the tele- 
phone breaks in upon his troubled dreams 
like sweet music. — Benedict (Lippincott's 
Magazine. ) 

Practice of Medicine in Iowa. — 

The State Board of "Medical Examiners 
has refused to recognize diplomas from 
Barnes Medical College, of St. Louis, as 
entitling their holders to enter the examina- 
tions of Iowa. — Northwestern Lancet. 

Pomegranate, New Alkaloid of. — 

Piccinni has isolated from the bark of 
pomegranate root, a new alkaloid that is a 
liquid and likewise miscible with water. — 
Chemische Centralhlatte. 




Book Reviews. 

King's American Dispensatory. Edited by Har- 
vey Wifckes Felter, M. D., and John Uri 
Lloyd, Phr. M., Ph. D.: Eighteenth Edition 
and third revision. Cloth, royal 8 vo.; pp. 
2291; Two volumes. Price, $9.00. The Ohio 
Valley Co., Cincinnati. 

This is, by long odds, the most complete 
epitome of materia medica and pharmacology 
ever issued from the press: Its scope is such 
as to dwarf all other dispensatories, and the in- 
formation conveyed (notably), has been edited 
with a care that seldom accrues to any work 
of this class. It practically puts to shame the 
National and the United States Dispensatories 
with which, revision, for years, has meant lit- 
tle but the embodying of a few new prepara- 
tions, often of no merit. 

The original King's Dispensatory was narrow, 
empirical, and uncertain in scope and adjuncts, 
and morever strongly tinctured with the tenets 
of Thomsonianism and the so-called "botanical 
practice;" and this has obtained in some 
degree to all subsequent editions up to the one 
now under consideration — "Eclectic" in name, 
for the first time only has this work reached 
the high plane indicated by its title. 

The new volumes are broad, scientific, and 
in every way reliable. Professor Felter is well 
known as an authority on therapeutics, espec- 
ially the branch that more particularly comes 
within the scope of his school, and that he has 
not slighted his subjects the text bears ample 
evidence. Professor Lloyd, too, stands in the 
front rank of American chemists, botanists and 
pharmacologists, and moreover has justly earn- 
ed a reputation for scientific ability and ex- 
actitude such as accrues to but few. Hence 
these volumes represent the acme of pharma- 
ceutical, botanical, chemical and therapeutic 
accuracy and advancement. 

The work as a whole is a worthy one, and no 
professional man who has accurate therapeu- 
tics at heart can afford to be "Without it. 

Professor Lloyd makes the explanation that 
in 1880 he promised Doctor King to revise the 
pharmaceutical and chemical sections of the 
American Dispensatory if such became neces- 
sary; that he did not understand the magnitude 
of the undertaking which constituted practical 
rewriting. He adds that monetary considera- 
tions could not have induced him to undertake 
this enterprise and, that the exacting researches 
necessary have been altogether a work of love. 
We have only one adverse criticism, namely: 
A number of drug preparations are spoken of 
as "specific;" this word is nowhere explained 
and apparently finds place solely with the view 

of advertising the preparations of one house, 
and the work thus, practically, becomes an ad- 
junct of an individual Eclectic school; we un- 
derstand these "specific" drugs to be of the 
same precise standard as Pharmacopceal fluid 
extracts except, perhaps, that in some special 
instances they are derived from the green, 
crude product. 

This fact, however, does not in any sense 
militate against the actual value of the work, 
as before mentioned, though it certainly is the 
reverse of good taste. 

New Instruments and Devices. 


This illustrates an instrument that, though 
not entirely nev/, is a modification of an exist- 
ing form that cannot fail to secure the full 
appreciation of the medical fraternity. 

It is a Lliiii, llexible vclvet-fiuislied rubber 
catheter, with an elastic button at the end so 
that it may be drawn over a stylet for the pur- 
pose of facilitating introduction into the blad- 
der. The button or bulging portion enaoles 
it, likewise, to be employed with certainty as a 
self-retaining catheter for either sex. It is also 
uqually useful as a drainage tube, not alone 
for the bladder but for the chest cavity after 
the operation for pyo- or hydrothorax, — it is 
valuable in any cavity where compression is 
not so great as to interfere with its lumen. 

The value of this device can hardly be over- 
rated in cases of cystitis and urethritis with 
enlarged prostate, or where, through sensi- 
tiveness, constant catheterization becomes un- 
bearable and the employment of cocaine (as 
it almost always is in the urethra) a menace. 

This is a soft rubber catheter made in two 
parts; or in other words is composed of two 
distinct tubes joined together in such a way 
that introduction is not only simple but facili- 

The advantages of the design are, it is thoro- 
ughly aseptic and furnishes a large and con- 
tinuous lumen for the efferent tube carrying 
off the urine. — This is especially valuable when 
the urine is very dense or heavily laden with 

It is also available for irrigating the bladder 
in cystitis with solution of potassium perman- 
ganate, as recommended by Doctor Valentin'^ 
of New York. 



Therapeutic Brevities. 

Indication for Venesection. — Bleeding 
[may be employed to good advantage in : 

Diseases of the nervous system, menin- 
[geal inflammations, cerebral congestion, and 
fapoplex} : 

Diseases of the kidneys, where there is 
.generalized cedema with un-emic symptoma 
[ — here venesection acts both as a depleting 
tprocess and as a sudorific : 

In circulatory troubles consecutive to 
'cardiopathies, — it unloads the venous sys- 
tem and augments arterial tension : 

In pneumonia its efficacy is remarkable 
and recourse should be had thereto at the 
; outset; it eases the patient by suppressing 
:pain in the side and rendering the respira- 
rtion and circulation freer ; likewise dimin- 
iishes the engorgement and pneumonic exu- 
date. — If the heart should ultimately flag, 
there need be no hesitation in repeating the 

In chlorosis: — One or more bleedings at 
from four to five weeks' interval constitute 
a sovereign remedy, and the more the blood 
is altered, the more the operation is indi- 
cated. — Note : A simple method, little 
known, of appreciating the alteration of the 
blood without the hicmatoscope and the 
haematometer is, collect a few cubic-centi- 
metres of blood in a straight tube and al- 
low to remain for twenty-four hours; 
two-thirds should then be occupied by the 
clot, above which should be seen a fine red 
layer composed of leucocytes, while the up- 
per third is occupied by serum of a straw- 
yellow color; the more the appearance dif- 
fers from this, the more the blood is altered, 
and the more is bleeding indicated. — Kac- 
ZER {Wiener Klinische Rundschau.) 

Glaucoma. — This condition is frequent- 
ly relieved by improved nutrition, with 
correction of any existing errors of re- 
fraction ; also, sometimes, by iodide potas- 
sium, associated with the topical employ- 
ment of eserine drops. 

Mild and insidious cases of inflammatory 
character, between paroxysms, may exhibit 
but little tension ; such require iridectomy 
for the drainage of the engorged vessel? 
during the paroxysm, and constitutional 
treatment to aid in the elimination of ac- 
cumulated debris in the tissues. 

Inflammatory glaucoma, excluding trau- 

matic cases, should be accepted as a mani- 
festation of many diatheses ; and while iri- 
dectomy may be necessary, it should not bii 
performed to the exclusion of the al'.-i;; 
portant constitutional measures. Moreovci 
as the operation can accomplish nothing bo 
yond the establishment of drainage- of thu 
vessels of the iris and contiguous slructurel 
into the aqueous chamber, the amount of 
iris removed should be small. The opera- 
tion should not be repeated, and in any ca.'50 
is only supplemental to constitutional meas- 

In all cases of increased tension of the 
eye, with peripheral contraction of the field 
and engorgement of the retinal veins with 
or without cupping of the disc, constitution- 
al treatment is essential; and, above all, 
strict attention to general nutrition and 
habits of life. — Reynolds {Ophthalmic 

Dysentery. — This is an acute infectious 
disease, and like most of its class has a 
tendency to get well in time ; still is 
of sufficiently serious nature to demand 
treatment. It is hardly necessary to re- 
view the many drugs which have been 
recommended ; the majority are useless, 
in many cases pernicious. Large doses of 
ipecac werjs very popular at one time, 
and, doubtless, efficacious in many in- 

The cause must first of all be eliminat- 
ed : Next disinfect the mucous mem- 
brane and restore the normal glandular 
secretion, which is best done by admin- 
istering magnesium sulphate in drachm 
doses, every three hours, combined with 
ten drops of dilute or aromatic sulphuric 
acid. The beneficial' effect is shown in 
a few hours : The pain becomes less ; the 
tormina and tenesmus rapidly subside; 
the pulse rate diminishes, and the tem- 
perature is lowered. When these effects 
are apparent, the Epsom salt may be 
gradually withdrawn. — Cruikshank {New 
York Medical Journal.) 

Uterine Deviations. — The use of gly- 
cerin and ichthyol tampons in the treat- 
ment of retro-displacements, and particu- 
larly in those complicated with the perimet- 
ric inflammation, where it can be persist- 
ently and thoroughly carried out, is of great 
value. Glycerin, by its affinity for water, 
depletes the tissue ; ichthyol, five or ten per 



cent, (in glycerin) will alleviate pain and 
hasten absorption. Replace the uterus and 
introduce one tampon into the posterior 
vaginal fornix, packing quite firmly; — this 
will press the uterus anteriorly ; then intro- 
duce another (larger,) straight into the 
vagina against the anterior lip of the cervix, 
to hold the first in place, and to raise the 
uterus, thereby increasing the ante-position 
and also improving the circulation by 
straightening the pampiniform plexus of 
veins. Finally, in treatment of uncompli 
cated retro-deviation by a simple operation, 
advance the anterior vaginal wall higher 
upon the uterus. — Shimonek {Mihvaukee 
Medical Journal.) 

Laryngeal Tuberculosis. — Congestion 
of one vocal cord is very suspicious of tu- 
berculosis, and a week's treatment by potas- 
sium iodide will exclude syphilis. 

The prognosis is not so grave as was 
formerly supposed ; the laryngeal process 
may heal even with progressing pulmonary 
tuberculosis. No sharp, irritating foods or 
drinks should be allowed, and the patient 
should be forbidden to use the voice, even 
in a whisper, communicating entirely in 
writing until cicatrization has progressed 
for a few weeks or months. When it is 
found that the' parts do not become congest- 
ed or swollen from whispering, then the 
use of the voice can be gradually resumed. 
Treatment may be by means of solution of 
lactic acid, not oftener than every one or 
two weeks. If possible remove all the 
diseased tissue by an endo-laryngeal opera- 
tion. In advanced cases with much stenosis, 
tracheotomy is preferable to laryngo-fissure. 
— Schmidt {Thcrapie der Gegemvart, Ber- 

Giaourdi. — Boil milk for one hour, con- 
stantly stirring. When it has reached the 
desired consistence, add a fig ferment and 
reduce the temperature to 113° Farh. The 
result is a smooth, semi-solid, easily digest- 
ible milk-food, which while not materially 
different from "bonny-clabber," possesses 
many advantages over the latter — the fig 
ferment produces a soft, smooth coagulum 
that is the more digestible because of the 
lack of lactic acid. This preparation has 
proved very satisfactory in gastric ulcer, 
pyloric stenosis and neurasthenia. 

The ferment may be made by soaking 

a dry fig over night in three ounces of wate 
next morning adding a trace of renn^ 
along with a few drops of lemon juic 
Many Swiss cheese-makers employ the ii| 
ferment as an addition to rennet, since ther< 
Ijy a much finer flavored and more home 
geneous product is obtained. 

Giaourdi is in general used in Greece an| 
the Levant. — Achilles Rose. 

Gleet and Gonorrhea. — Triturate fi^ 
drachms of acetanilid and 120 grains goldc 
seal with three ounces of glycerin and 
water sufficient to bring the finished pro- 
duct up to one pint. This should be em- 
ployed as an injection, after shaking well, 
at least three times daily, following immedi- 
ately upon micturition, the fluid being re- 
tained in the urethra for at least four or 
five minutes. Under ordinary conditions a 
cure may be expected in from fourteen to 
ninety days. 

If the patient is emaciated, the bowels 
should have due attention ; also a tonic may 
be administered, something of the character 
of the following: 

Strychinine sulph... 2 grains 
Hydrastis, powd.... 3 drachms 

Glycerin 3 ounces 

Ginger, ext. fid 3 ounces 

Alcohol 5 ounces 

Water to make.... 16 ounces 
A teaspoonful every three hours or as de- 

— Washburn. 

Bees for Rheumatism. — Some years 
ago an Austrian physician advanced the 
theory that the virus of the bee sting is an 
infallible remedy for acute rheumatism, a 
fact that receives unquestionable confirma- 
tion from a custom of the country people 
in Malta. Bees are plenty in this island, and 
their stings in such repute that resort to this 
primitive method of inoculation has been 
a common practice, in severe cases of rheu- 
matism, for generations, with most satisfac- 
torv results. — Mediterranean Naturalist. 

Hydrogen Peroxide. — The activity of 
this chemical is promoted, when employed 
externally or internally, by the addition of 
hot water. A teaspoonful added to a half 
glass of the latter and ingested just prior to 
meals, exerts a powerful remedial influ- 
ence upon catarrhal gastritis. — Elling- 




Chorea' Complicating Pregnancy. — 

Chorea is not an accidental complica- 
tion due to the occurrence of a previous 
infantile chorea, but in the majority of 
ases appears for the first time, and to a 
L;reat extent is induced by this condition, 
although pregnancy alone can not be re- 
garded as the direct cause ;" various con- 
ditions such as heredity, previous infec- 
tive diseases, etc., are predisposing fac- 
tors, and some nervous shock is usually 
the starting point. 

The prognosis is more grave than in 
early life. In severe cases ether and 
chloroform may be given, as in eclamp- 
sia : Pinard suggests producing almost 
continual sleep (waking the patient only 
to administer food), by means of chloral 
h3'^drate ; when improvement appears, the 
(loses can be diminished, but should be 
continued until this desideratum obtains. 
— Newell (Medical and Surgical Journal, 

Indolent and Stubborn Ulcerations. — 

After an ulceration has partially healed, 
it is often found, when a certain stage is 
reached, that it no longer improves. One 
of the best applications for this condition 
'^f affairs is oxyde of zinc ointment every 
unce of which is fortified with ten grains 
chloral hydrate — the chloral seems to 
stimulate and promote the granulating pro- 
cess. — Medical Summary. 

[In many instances the delay in healing 
is due to the tension of the parts. Here 
strapping with adhesive strips, in a way 
to secure relaxation of the tissues in the 
immediate neighborhood of the ulcera- 
tion, secure results that are almost magi- 
cal. — Ed.] 

Asthma, — This condition, regardless of 
cause, may sometimes be relieved by apply- 
ing a bag of ice to the neck over the pneu- 
mogastric. — Sanger. 

[It might be well to try also the appli- 
cation of cantharidal collodion in the same 
locality. — Ed.] 

Trachoma. — Excision of the retrotarsal 
fold is the best method of treatment, an 
operation that always proves successful and 
can be performed without difficulty. — Kan 
( Vratch. ) 

Uterus, Influence of on Bladder. — In 

view of the intimate vascular and nervous, as 
well as mechanical and topographical, rela- 
tions of the uterus to the bladder, it is ad- 
vised that in all cases of vesical trouble in 
women, the uterus should first be examined, 
and existing lesions corrected. Relief of 
the bladder symptoms may be obtained in 
this way by curettage, uterine dressings, or 
pessaries, or at the time of menstruation by 
relieving pelvic congestion by diuretics, 
laxatives, hot baths, or even local bleeding. 
— Vergely {Medical and Surgical Moni- 

Sodium Chloride, Lack of in the Econ- 
omy. — When the system is deprived of 
its normal supply of salt the nervous tissue 
becomes more susceptible to medicinal salts, 
in consequence of which extremely small 
doses becomes efifective. In this manner, 
for instance, thirty grains of -odium brom- 
ide given during twenty-four hours proves 
remarkably helpful in severe cases of epi- 
lepsy. Probably this is also true of the- 
alkaloidal salts. — Richet {U Union Medi- 
cale. ) 

Urinous Odor, Correction of. — Essence 
of turpentine taken internally in ten-drop 
doses, three times daily, by persons afflicted 
with urinary incontinence, in a short time 
does away with the disagreeable ammonia- 
cal odor, replacing it with the flavor of 
violets. This treatment can be continued' 
without inconvenience for several weeks,, 
and is only contra-indicated in gastric ca- 
tarrh and nephritis. — Kansas Medical Jour- 

Influenza of Childhood. — 

Sodium benzoate. 30 grains 

Phenazone 30 grains 

Sparteine sulph.. 2 grains 

Paregoric 4 drachms 

Liquorice extract 1 drachm 
Tolu syrup to maite 2 ounces 
Shake well: A teaspoonful four times daily 
for a child of six to eight years of age. 

— Merck's Archives. 

Furuncles. — Salicylic acid in the form 
of ointment or paste, constantly applied,, 
will relieve the pain and tumefaction. Early 
resort thereto will usually secure abortion 
of the initial purulent accumulation ; applied 
later, it will at least hasten and promote 
resolution, — Hartzmann. 



Cocaine Muriate. — In small doses this 
drug slows the pulse rate, but this effect 
persists only for a brief period ; is in fact 
ephemeral. Larger quantities, as might 
be expected, intensify this action, and if 
the toxic effect is produced, arrest of the 
heart in diastole results ; trigeminal paraly- 
sis is also induced. The slowing of the 
pulse depends on irritation of the vagi, 
since it can be inhibited by the simultane- 
ous employment of atropine. 

Large doses induce speedy paralysis of 
the cardiac ganglia, preceded by elevation 
of blood-pressure, induced by the stimu- 
lation of the vaso-motor centres as well 
as by a direct action upon the organ 
itself. — Wasserzug. 

Pilocarpine in Eye Maladies. — Grati- 
fying results are obtained in the treatment 
of interstitial keratitis, traumatic purulent- 
iritis, vitreous opacities, and retino-choro- 
iditis. Some place great reliance upon the 
drug in toxic insanity supervening upon 
influenza, auto-intoxication, and similar 
processes, the brain rapidly clearing after 
two or three free perspirations. Apart from 
its action hypodermatically, pilocarpine (or 
the fluid extract of jaborandi) in small 
doses by the mouth, has been found of value 
in degeneration of the vitreous. The per- 
sistent nausea so common after the use of 
the drug is usually relieved by small dos- 
es of chlorodyne. — Hansell (Philadelphia 
Medical Journal.) 

Rectal Prolapse in Children. — A taper- 
ing piece of ice, about three inches long 
and one inch in diameter (at the largest 
end), is wrapped with iodoform gauze, and 
its point pressed gently against the center 
of the prolapsed mass until it is replaced ; 
the ice tampon remains in the rectum with- 
out the use of any retentive bandage, pro- 
vided it is pushed in far enough. A fresh 
piece of ice is employed in this way after 
each act of defaecation. This treatment 
soon cures the prolapse, and seems to act 
by emptying the blood-vessels and hight- 
ening the contractihty of the rectum. — 
Hajech (Detitsche A'crtse-Zcitung.) 

Varicose Veins. — Inject Squibb's ergot 
by the side of the vessels, then give by the 
mouth one-eighth to one-half of a grain of 
barium chloride to contract the arterioles. — 


Dropsy. — Apocynuvi Cannabinum is ai 
old remedy possessed of immense value, 
and when given for certain direct indica- 
tions proves unfailing. (Edema of super- 
ficial cellular tissue, wherever found and 
however extensive, is a condition in which 
it will not fail 

Personal observation proves it to be a 
heart tonic of considerable value where there 
is flaccidity of cardiac muscle coupled with 
an atonic and relaxed condition of the gen- 
eral system ; with a tendency to adiposity 
and plethora, especially when effusion ap- 
pears, it will produce excellent results in 
small doses, say from one to three drops. 
In others, particularly if relief from the 
dropsical effusion is imperative, large and 
hydragogue doses may be given. — Elling- 


Constipation in the Young. — Constipa- 
tion is invariably due to errors in diet, either 
through the mother's milk or from im- 
proper artificial food. Massage the abdo- 
men gently with inunctions of cod-liver or 
of castor oil. Study the diet and regulate 
it according to the modified teachings of 
Rotch. Use glycerin injections or sup- 
positories, as necessary. In older children, 
feed prune juice, stewed dried peaches, 
dates, orange juice, and other laxative 
foods, and practice the same massage and 
inunctions. Give less drugs and practice 
more mechanical and dietetic hygiene, and 
you will have more satisfaction. — Medical 

Hay Fever. — Where no hypertrophy or 
permanent obstruction is present, but simpb' 
a turgescence of the mucous membrane, u 
the following : 

Arsenous acid 1 grain 

Strychnine sulph. ... 2 to 3 grains 

Belladonna, ext 4 grains 

Zinc phosphide 4 grains 

Gentian, ext 20 grains 

Make twenty pills and give one three times 

In conjunction employ a menthol prepara- 
tion locally. This is effective in any form 
of nasal neurosis. — Dabney {Northwestern 

New Use for Black Cohosh. — In pain- 
ful conditions existing in or around the eye 
or ear, the external application of the cimi- 
cifuga tincture will often give immediate 
relief. — Homoeopathic Recorder. 



Gymnemic Acid. — This is the active 
principle of Cymncma sylvestris, and is a 
greenish-white powder with pungent, sour 
taste, only slightly soluble in water. If a 
small quantity of the tincture, made by dis- 
solving the drug in alcohol, be placed upon 
the tongue, the taste of sweet things and 
of bitter things is entirely destroyed; no 
other effect is produced, for taste is as sen- 
sitive as ever to 'other substances. If the 
mouth is rinsed with a twelve per cent, solu- 
lion of the acid before taking any bitter 
nbstance, the latter will not be tasted. — 
i hicago Medical Times. 

Solidago Virgaurea. — This is a foreign 
species of golden rod, one used as a domes- 
tic remedy, for backache and diseases of the 
kidneys generally, in Germany, for centuries. 
Homoeopathic physicians prescribe for renal 
pain, or pain in circumscribed spots in the 
region of the kidneys ; for pains in back, 
extending forward to the abdomen; in 
dysuria, difficult and scanty urination, dark 
urine with sediment (either of the phos- 
phates or blood or pus) ; useful also in pro- 
nounced nephritis. — Rademacher. 

Ergot and Uterine Inertia. — An excel- 
lent way to give the medicament is, to di- 
lute a teaspoonful of the fluid extract iti 
fifteen teaspoonfulls of water, in a glass, 
and give a drachm every ten minutes until 
improvement occurs. The treatment should 
be ])egun early to secure the best results ; 
and even then the remedy is inferior to can- 
nabis Indica, providing a reliable prepara- 
tion of the latter can be obtained. — Medi- 
cal Rczieiu (Birmingham). 

Bilious Colic. — Dioscorea villosa is un- 
doubtedly as much a specific in bilious colic 
as is quinine in intermittent fevers. The 
dose of fluid extract is from five to thirty 
minims — which may be doubled in emer- 
gency ; of the solid extract, one to four 
i^Tains every one to four hours, according 
to urgency. The remedy is useful in flatu- 
lence of the bowels. — Bacon. 

Uterine Fluxes. — Hydrastine is the 
most valuable of all remedies. Use hypo- 
dermatic injections of five to ten drops of 
the hydrochlorate in ten per cent, solution. 
There is no pain or discomfort from the 
operation . — Falk. 

Tonic, a Valuable. — Phosphate of soda 
combined with ergot affords favorable re- 
sults in melancholia, hysteria, adynamia, 
and chlorosis ; it overcomes the great con- 
stitutional depression of the algid stage of 
certain fevers. Sodium phosphate alone 
has been employed in the cerebral torpor of 
senility, but the combination with ergot 
increases its efficacy. The general indica- 
tion for the administration of the mixture 
is functional debility of nervous origin. — 
Luton {Journal de Medicine de Paris.) 

Haemorrhoids. — More than once I have 
found great relief or temporary cure to 
speedily follow upon the free use of dis- 
tilled extract of hamamelis as a rectal in- 
jection. The quantity used is from two 
to four drachms, frequently, during the day 
and evening. No unpleasant results accrue. 
It may be that those who have been disap- 
pointed trusted to internal administration 
or too scanty local application of the drug. 
— De Waterville. 

Warts and Moles. — Twice daily touch 
each with enough glacial acetic acid to 
saturate without allowing to touch the 
healthy skin. If this results in soreness, 
too much acid has been employed ; sus- 
pend for forty-eight hours, and again 
resume. The 'warts and moles turn brown, 
rapidly disappear and leave no scar. There 
is no danger. Do not tell the patient what 
is being used, though it may safely be placed 
in his or her hands, with cautions. — Tay- 

Cranberries. — The pure, fresh juice of 
raw cranberries, given freely, either undi 
luted or with an equal part of water, is an 
excellent means of relieving the thirst in 
fever and moreover is markedly antipyretic. 
In the thirst and vomiting pecidiar to 
cholera it is even more eft'ective. In fifty 
cases in which ice and narcotics failed to 
make the slightest impression, cranberry- 
juice, in small but repeated doses, rapidly 
checked both vomiting and nausea. — GoRi- 


Nasal Catarrh. — Most ozaenas and ca- 
tarrhal discharges are readily relieved by 
the exhibition of berberis. If the High- 
morean antrum is implicated, relief is 
prompt if the remedy is administered in 
full doses. — Heitzman. 



Nitrous Oxyde and Ether. — The ad- 
vantages of the combined method of using 
nitrous oxyde with the Bennett inhaler, fol- 
lowed by ether, have been shown it in all 
cases operated on during- the last eight 
months in Doctor Kelly's private hospital. 
It seems to possess so many advantages to 
the patient, operator and anaesthetizer, and 
so few disadvantages, that it has become a 
distinct part of the operative technique. — 
Philadelphia Medical Journal. 

Iodoform in Lupus. — Excellent results 
can be obtained by the hypodermatic injec- 
tion, at a distance from the seat of disease, 
of iodoform dissolved in a neutral petrol- 
eum. Improvement generally appears after 
twenty-four or forty-eight hours, and is 
well marked at the expiration of five or six 
days. — Lavalier (Journal des Maladies 
Cutanccs ct Syphilitiques.) 

Heart Maladies and Alkaloids. — The 

best authorities are united in discouraging 
the use of the active principles of digitalis, 
strophanthus and convallaria. in the treat- 
ment of cardiac disease. The best effects are 
obtained by employing the tinctures, prefer- 
ably the "mother tinctures" so-called, of the 
Homoeopath. — Medical Gazette (Bombay). 

Influenza. — Infusion of boneset is one 
of the best remedies for the treatment of 
la grippe, inasmuch as it reduces temper- 
perature. acts as a sedative and alterative, 
and appears to be grateful to the patients. 
— Brodnax. 

[The foregoing has our hearty endorse- 
ment. — Ed.] 

Stomach Anodynes. — Atropine checks 
the gastric juice almost completely, but 
morphine increases it. When secretion 
is excessive, as in ulcer, morphine is con- 
traindicated, and one of the belladonna 
preparations will act better. — Biegel ( Thcr- 
apic dcr Gegenzvart.) 

Cystitis, Chronic. — Rhus aromatica, 
ammonium muriate, potassium citrate, com- 
bined, do well, but the dose of the ammon- 
ium salt must be large to be of real or lasting 

r aUvays advise the urine be rendered 
alkaline by some potassium salt combined 
with a vegetable acid. — ^Joseph Ai)OLPHUS. 



Scarlatina, — Few cases of scarlet f 
are not benefited by the constant, almos 
continuous, exhibition of small doses of 
tincture of aconite and belladonna — say 
one-fourth or one-half minim of the form- 
er, and one-sixth minim of the latter.^ 
Potassium bichromate is very satisfactory! 
for the angina, and daily inunction by 
means of cacao Initter should not be neglect- 
ed — this latter aflfords nourishment, favors 
desquamation, and reduces the fever. — 
Stock WELL. 

Hydrastis. — This is a very good rem- 
edy in constipation. Hughes, in his "Phar- 
macodynamics," recommends a drop of the 
mother tincture in water before breakfast. 
A globule of the first attenuation, once or 
twice daily, has been given by me on many 
occasions and I can recall no failure. — 

"Bone" Felons. — To abort before sup- 
puration has set in, cover the swelling to 
the thickness of an eighth of an inch, with 
citrine ointment. This must be kept in 
place by a non-absorbent bandage, and put 
on fresh every eight hours, until all signs of 
inflammation have disappeared. — Lum- 
MiNS (Medical Suntnwry.) 

Gonorrhoea! Buboes. — Apply, thrice 
daily, with friction, one part each of oil of 
sassafras and oil of peppermint, dissolved 
in sixteen parts strong tincture of capsi- 
cum. — Washburn. 

Albuminuria. — Try one drop of a one 
per cent, solution of nitro-glycerin. three 
times daily. This often will relieve the pa- 
tient in a few days. — Northivcstern I^ancet. 

Mosquito Bites. — Naphthalan is an ef- 
fective remedy for mosquito l)ites. Its ac- 
tion on the ])oison is effective and specific. 


Uterine Inertia. — Strong hot coffee, 
drunk without seasoning, will usually prove 
effective. — Joseph Adolphus. 

Diphtheria. — Local treatment is cruel 
and brutal whenever and wherever applied. 
— Jacobl 



Medical Progress. 

Disease Odors. — 

Of the specific odors of disease two very 
marked cases come to mind : One, a young, 
Inixom, red-cheeked woman, whose men- 
strual discharge was accompanied by such 
a pervasive odor that few could stay in the 
same room with her ; the other, a man who 
sutTered from profuse foetid perspiration 
confined to the axillary regions — the fluid 
could be seen constantly exuding, of a con- 
sistence a little heavier than normal perspir- 
ation, the disagreeable odor it yielded being 
very penetrating, so much so as to pervade 
the' whole room and adhere to the furniture 
for hours after his departure. 

The ammoniacal smell common to the 
aged, and due to retained or dribbling urine 
is well known. Berard says that, apart 
from the excretions, an abnormal odor of 
the skin tends to draw flies, and that how- 
ever little noticeable it may be it denotes 
death is near; and Boerhaave held that a 
cadaveric odor always presages death. — 
Althaus tells us that Skoda was hardly 
ever led into error by this indication,* 
and Compton also laid great stress upon 
this as a clinical symptom ; but the smell 
given off during the "death-agony" is 
totally different from the death odor (that 
of putridity) and is universally admitted 
to be specific. 

The. odors obtaining to sex are vastly 
dififerent, thus in man it suggests mush- 
rooms, in woman codfish. * 

In gout the skin secretions take a special 
odor which Sydenham compared to whey ; it 
is sour, or at least sourish, as there is an 
excess of ammonia. In rheumatism it is 
acetoformic, particularly in the regions of 
engorged articulations (Monin) ; it is a 
sour-smelling, acid perspiration. 

In diabetes the smell is- sweetish and 

*[An odor of semen persisting about the body 
and apartment of an old man, even if he does 
not appear seriously ill, appears to be indicative 
of speedy dissolution. This is invariable, 
though why, except it is in a sense cadaveric, 
we are unable to explain. It most frequently 
obtains in connection with suppression of urine, 
and in the majority of cases points to pros- 
tatic disease of long standing. — Ed. I 

t [The odor of a perfectly heaitoy, cleanly 
woman should be that of thyme; the codfish 
odor is evidence of lack of personal cleanli- 
ness as regards the sexual organs, or of a 
diseased condition. — Ed.] 

mawkish, as of hay, according to Latham, 
"acetone" says Picot, and "midway between 
aldehyde and acetone, being due to a mix- 
tiu-e in variable proportions of the two 
bodies," according to Bouchardat. 

A musky odor obtains to several maladies, 
notably peritonitis, jaundice and icterus; 
and a stale, sour-beer odor to scrofulosis. 

The pysemic person has a sweet, nauseat- 
ing breath, with perhaps a flavor of new- 
mown hay. 

In milk fever the smell is distinctly acid ; 
in typhoid, musty, often with the odor of 
blood; in typhus, ammoniacal and mouse- 
like, which latter also obtains to favus ; in 
intermittent the odor is that of fresh-baked 
Ijrown bread; yellow fever has a cadaveric 
smell, or like the washings of a dirty gun- 

In measles it closely resembles fresh-pick- 
ed feathers ; in diphtheria, is sickening and 
gangrenous — an odor that is absolutely 
pathognomonic; in smallpox, according to 
severity and stage, it ranges from that of 
the fallow deer to the dreadful one of the 
whole menagerie, or it may be that of burn- 
ing horn or bones. 

Hysteria usually develops an odor of vio- 
lets or pine-apples ; sudamina, that of putrid 
straw ; scabies, mouldy ; anaemia and chol- 
era, ammoniacal (Drasch, Parker) and the 
discharges have either a semen or mush- 
room flavor. 

Otorrhoea has a peculiar, clinging, long- 
lasting odor that once observed will never 
be forgotten ; so, too, is the odor of a hen- 
roost that obtains to ozsenas and bad chronic 
catarrhs. Gangrene has an old, dead-meat 
smell, as have some cancers at certain stages, 
— if there is much pus from an actively 
breaking-down, malignant growth, and es- 
pecially in sarcomas, it is more like decaying 

At the onset of the plague the odor is 
sweet (Diemerboeck) or honey-like accord- 
ing to Doppner. 

The atmosphere surrounding the chronic 
onanist will have a rotten mushroom-like 
odor, and an ill-kept libertine will combine 
this with a cod-fish smell. — Clarke {Horn- 
oeopathic Medical Recorder.) 

Value of Meat Extracts. — 

Doctor A. McGill, in a report to the In- 
land Revenue Department, Ottawa, Can- 
ada, observes that much has to be done 
by experimental physiologists before final 



pronouncements can be made upon the 
food value (if any) of the flesh bases, 
which, in most instances, form the chief 
portion of the nitrogenous material in 
meat extracts. The bases certainly dif- 
fer among themselves in food value, and, 
. of course, if this is true of the flesh bases, 
it is, a fortiori, true of the various forms in 
which proteid matter occurs in these 
preparations, viz., as peptones, proteoses, 
acid albumens and so forth. Doctor Mc- 
Gill's experiments suggest that a part of 
the nitrogen in some meat preparations 
exists as urea. Urea certainly can have 
no food value, nor can one really under- 
stand how the allegation that it is of use 
as a stimulant can be justified. Nature 
seems to have provided for its prompt 
elimination from the system, and it is 
certain that any failure to get rid of it by 
way of the kidneys results in serious dis- 
turbance of the vital functions, and may 
end in death by uraemia. No practical 
method has been discovered by which a 
sharp analytical line can be drawn be- 
tween the nitrogen present as urea and 
that present as creatin, creatinin and 
xanthin. It is evident that the flesh bas- 
es cannot be called food stufT in the prop- 
er sense of that term. They represent a 
stage of the process by which complex 
nitrogen compounds are changed to sim- 
ple ones, supplying the energy so set free 
to the animal organism in the form of 
vital force. They may still have some food 
value, since they are not excreted as such, 
but undergo further simplification, till 
they appear as urea. It is certain that 
their food value is very much less than 
that of proteids proper. When once the 
urea stage is reached, the urea must be 
promptly got rid of. The blood is the 
vehicle by which nutritive matter that 
has been digested and made soluble is 
conveyed to all parts of the body; and it 
is also the vehicle by which waste mat- 
ter is conveyed to the lungs and other 
excretory organs to be eliminated. Flesh 
bases are always present in the blood, 
though in small amounts. They are 
much more largely present in muscle tis- 
sue, and when fresh lean beef is treated 
with hot water, these flesh bases are the 
chief material taken into solution. Apart 
from any possible nutritive value which 
they have, these flesh bases undoubtedly 
possess a stimulant action on the system 
analogous to that exhibited by the alka- 

loids of tea, cofifee and cocoa, and it i 
beyond question that to this stimulating 
effect, rather than to any true nutritive 
power, they owe such value as they pos 
sess. — British Food Journal. 


Bacteria a Vital Necessity. — 

The presence of certain bacteria in the 
air is as necessary as oxygen for the con- 
tinuance of vital processes in animals. When 
animals are confined for some days in a 
chamber of sterilized air, some die, and 
those taken out alive expire shortly after- 
wards or, if they survive, show symptoms of 
extreme lassitude and weakness. These re- 
sults are due neither to starvation, nor to 
toxic exhalations, nor to the presence of CO^ 
in the sterilized air. The urine excreted by 
the subjects is found to be abnormally rich 
in leucomaines, while the quantity of urea 
present is very low, showing that the pro- 
cesses of oxydation, which normally go on 
in the tissues, were materially retarded. The 
oxydizing ferments which have been shown 
to be normally present in the tissues are 
supplied by bacteria, which gain access to 
the blood and. probably, to the leucocytes 
in the lungs. The actual cause of the debil- 
ity and death in the animals experimented 
on may be considered to be the enormous 
accumulation of insufficiently oxydized pro- 
ducts which exercise a toxic influence. Bac- 
teria are, therefore, considered to be essen- 
tial to the maintenance of animal life. — 
KijNiziN {Pharmaceutical Journal and 


The Earliest Human Ovum. — 

Leopold recently exhibited microscopic 
sections of the youngest human ovum ever 
detected. The uterus of a woman, aged 
thirty, was removed for cancer of the 
cervix, the interior carefully examined, and 
an undoubted ovum the size of a lentil 
found making a prominence on the surface 
of the uterine mucous membrane, which was 
hypertrophied in its neighborhood. The 
periphery of the ovum was bounded by a 
deep groove devoid of mucous membrane. 
After careful inquiries it was concluded that 
the ovum had reached the eighth day after 
conception. Great pains was taken to 
secure successful sections. The arrange- 
ment of the villi, and the opening of the 
arterioles of the endometrium into the in- 
tervillous spaces, came out very clearly. 

Kanthack has recently added to the 



museum of St. Bartholomew's an instructive 
specimen of a very early human ovum in its 

Histological study of the human embryo 
and its envelopes during the first few weeks 
of development is much needed. We must 
not rely too far on homologous structures 
in the lower mammals, where the anatomy 
and physiology of the genital tract differ in 
important details. — British Medical Journal. 

Voluminous Retro-Pharyngeal 
Abscess. — 

A boy of eleven months began to suft'er 
• from cervical adenitis with suppurating 
glands, and incision liberated a large quan- 
tity of pus. Later it wag noticed the 
child had trouble in swallowing, which 
steadily increased until brought for examin- 
ation. A visible bulging of the posterior 
pharyngeal wall was discovered, almost 
touching the base of the tongue and filling 
the bucco-pharyngeal cavity, causing diffi- 
culty in swallowing and respiration. This 
was a voluminous retro-pharyngeal abscess 
consecutive upon suppurating cervical 
glands, which was immediately incised, the 
child being held on the knees of an as- 
sistant, and immediately bent forward. 
Notwithstanding these precautions, the 
pus was so considerable that it caused 
asphyxia. The pharynx and larynx were 
well mopped out, and the child being laid 
flat on a table, rhythmical tractions of 
the tongue and artificial respiration were 
practiced, along with flagellation of the 
cardiac region. In fifteen minutes respira- 
tory movements began. Complete recovery 
in six days. — Traver (Revue Hehdome- 
daire de Laryngologie.) 

The Twentieth Century Baby. — 

The baby of to-day, as a matter of sober 
fact, is threatened with manifold drawbacks 
to development short of actual extinction, 
by the wholesale substitution of the artifi- 
cial for the natural. Instead of the most 
perfect food in Nature, mother's milk, we 
find a host of artificial substitutes, each one 
of them, calculated to rear an infant with 
the brains of a Newton combined with the 
frame of a Sampson. How often, alas ! the 
outcome of all these costly cares is a being 
of stinted body and limited intellect, unfitted 
to play a soldier's part in the battle of life. 
This question of food strikes deep into the 
physical welfare of a race, and there can 

hardly be a more serious National problem 
than how to rear this Twentieth Century 
baby of* ours in strength and happiness. 
There is a vast deal of nonsense written and 
taught about the proper way -to clothe, nur- 
ture, and tend babies generally. The best 
basis is that of plain milk diet, either from 
the breast or from modified cow's milk : For 
the rest, those ills that are preventable 
should be prevented. Most of the mischief 
done in the nursery is the result of attempt- 
ing to do too much! It would be an impor- 
tant step toward the stabiUty and future 
of our race were the laws of health to 
be taught in our schools, with a special 
class on nursery management for the girls' 
classes. — Medical Press and Circular. 

Urine, Oxalates In. — 

Calcic or calcium oxalate is rather a com- 
mon sediment, often mistaken microscopi- 
cally for a cloud of mucus; it is found in 
both acid and alkaline urine, especially after 
the patient has eaten freely of rhubarb, to- 
matoes and other vegetables rich in oxalic 
acid. The crystals are usually octahedral 
in shape, giving the appearance of a square 
crossed by two diagonal bright lines, like 
the back of a square envelope; they are 
much smaller than those of the triple phos- 
phate, from which they are further distin- 
guished by their insolubility in acetic acid. 
A much more rare form of calcium-oxalate 
crystal is that resembling a dumb-bell. 

Hippuric acid is occasionally met with as 
a urinary sediment, in the form, microscopic- 
ally, of fine needles or of four-sided rhombic 
prisms with beveled ends and edges. A de- 
posit of hippuric acid is met with most fre- 
quently after the ingestion of benzoic acid or 
of certain aromatic vegetables — cranberries, 
for instance. — Hill. 

Differential Diagnosis. — 

Acute general miliary tuberculosis and 
basilar cerebro-meningitis at times simulate 
typhoid. In the former, attention and 
minute examination of the patient, and the 
course of the morbid phenomena, quickly 
dissipate any doubts ; in the second, the pre- 
vious history of the disease, the mode in 
which it commenced, the course of the tem- 
perature, the absence of abdominal symp- 
toms, and the early appearance of delirium 
or coma, do not long allow hesita,tion in the 
diagnosis. — Homem. 



Fresh Air for Infants. — 

The most saHent point made by. Doctor 
Holt in his able address before the Cleve- 
land Medical Society, recently, was the im- 
portance of fresh air for infants. It is a 
striking fact that this one thing makes not 
only a perceptible but an enormous differ- 
ence in the mortality statistics of hospitals. 
Of the essentials, good food, and fresh air, 
the latter is by no means the least important, 
and the lack of this often determines the 
death-rate of seventy-five to ninety-five per 
cent, in foundling asylums. It is not reas- 
suring to note the fact that the wealthiest 
as well as the most intelligent people are 
taking the greatest pains to exclude fresh 
air from their houses. The modern house 
is furnished with weather-strips to prevent 
draughts, and with either steam or hot-water 
heaters which provide no ventilation at all, 
or a furnace with an air-shaft that draws its 
supply from the hall, thus preventing an in- 
flux of pure air from without, — all of which 
is well calculated to conduce to infant mor- 
tality. — Cleveland Medical Journal. 

Alopecia. — 

The most unpleasant and unsightly cases 
are the atrophic forms, in which coarse 
thick hairs are found on a dry scalp without 
baldness — cases that are practically hope- 
less. Nor is there much hope where young 
men become prematurely bald at the same 
age as when this condition overtook their 
fathers, — which would seem to indicate 
that the malady is of an inherited rather 
than an infectious nature, though it rarely 
attacks girls. Perhaps the reason why the 
female sex suffer less from alopecia is the 
fact they give more attention to their hair, 
and wear more suitable and better venti- 
lated headgear. — La Semaine Medicate. 

Typho-Malarial Fever. — 

In spite of "eminent" authority to the 
contrary, this term is the proper designa- 
tion for those asthenic forms of remittent 
fever with typhoid symptoms in which the 
typhoid bacillus is not present in the blood. 
It is a typhoid fever complicated by pre-ex- 
isting malarial infection or a malarial fever 
complicated by a typhoid. — Lillie. 

Gelatine Suppositories, Base for. — 

Gelatine forty parts ; glycerin, twenty-^ 
five parts ; water to make lOO parts, or, if a 
softer mass is required, 120 to 130 parts. 
The product is said to be well adapted for 
use with alum and other salts. The addi- 
tion of twenty-five parts of powdered acacia 
or dextrin in place of an equivalent amount 
of water renders the mass more suitable for 
use in summer or in a warm or moist atmos- 
phere. In either case the gelatine should 
be soaked in 200 parts of water until soft, 
the glycerin (and gum if required) added, 
and the whole heated on a water bath un- 
til complete solution is effected and the 
excess of water evaporated. Stir gently 
while heating,' and keep the temperature 
well below boiling-point. If air-holes ap- 
pear in the mass on cooling, it must be re- 
heated with 100 parts of water and the 
whole again evaporated to the required 
bulk. The moulds should be oiled before 
filling, and if made of metal, should pre- 
viously be heated to about 122° Fahr. — 
The Chemist and Druggist. 

Foreign Body in Maxillary Sinus. — 

Mignon, of Nice, reports an interesting 
case in which a young man, with suicidal in- 
tent, discharged a revolver against his tem- 
ple. A few days after the incident, as no 
symptoms of reaction occurred, an examin- 
ation by the radioscope was attempted, and 
it was found that the bullet was lying loose 
within the left maxillary sinus. — Archives 
dc Laryngologie. 

Invertin in Grapes. — 

There is present in the juice of all kinds 
of grape a sucrase, in quantities sufficient to 
invert the entire amount of saccharose pres- 
ent, without the assistance of any organic 
acid. The "invertin" is not present in wines 
attacked by bacterial diseases, and disap- 
pears entirely in wines which have been 
strongly oxydized. — Martinaud {Pharma- 
ceutical Journal and Transactions.) 

Pneumonia. — The appearance of labial 
herpes is a favorable sign in congestion of 
the lungs. — Denver Medical Times. 

Chorea. — 

This is a form of rheumatism — cerebral 
rheumatism, in fact — as is well borne out 
by evidence. — Dyce Duckworth. 

Osteomyelitis. — The chief diagnostic 
point is the acutely sensitive spot near the 
junction of the epiphyses. — Funkhauser. 



• , • 












, _.^ J. 

...5e:e: our... 



Page X. 

"Once We Get the 
Wedge In, the Task 
Is Easy." 

To demonstrate solubility, drop one in water ; it will 
disintegrate in thirty seconds. 

Antiseptic Spiienoids 

The Twentieth Century Treatment for 

Vaginal and Rectal Troubles. 




One each night, introduced into the vagina well up to the 
uterus, grlves prompt and permanent relief in all forms of 
Vaginal Catarrhs, whether specific or non-specific. For Hem- 
orrhoids and Sphincter Troubles, cover with petrolatum to 
facilitate insertion. iSend for I>e« Sample and Uter- 

PRICE, In One-Hair $1 ^Q Pontaare 
Oross Boxes, ^ •-^■^, Paid. 


■Manufacturing Chemists, Indianapolis, Ind. 


The most Compact, Antiseptic 
and Convenient Device for sub- 
cutaneous medication ever placed' 
upon the market. 

The case holds six vials besides 
needle and syringe, and is so curved 
as to conform to the shape of the 
body, thereby avoiding bulk, breakage, and unsightly 
bulging of clothing. Adapted to the vest pocket. 
Made only by 

The Randalf-raichney Co., 

iSTtxdbury Building, Sudbury iStreet, 






Yes, we'll do it, and are the only makers of 


who will place a 
and prove to you 

what we 


your office 
claim for it. 

H. P. ENGELN ®. CO., 


715-723 Ross Building, CLEVELAND, OHIO. 



•ir -r 


Morrison's Surg^ical 


THe Best 

Most Convenient 


Most Practical 

The Davidson Rubber Co., 

19 MilK St., BOSTON, MASS. 











PRICE $1.00. 

(Sent by mail prepaid.) 

A new and Scientific Instrument for deter- 


IN the: UR.INE. 

Can be detected when only 1-60 of one 
per cent is present. 


This simple little instrument should be in 
the hands of every Life-Iusurance Examiner. 


268 Woodward Ave., Detroit, Mich. 

2 Richmond Street E., Toronto, Ont. 








Surgical Instruments and 
PHysicians* Supplies. ^ W 

2 RicHmond'Street, EI.ast, 



368 Wood^vard Avenue, 





The Twin Bulb ISSS^cv An ideal Thermometer 

Quickest to Register. Easiest to shake down. Price, One Minute, BECTON, DICKINSON & CO., 

$1.25; Half Minute, $1.50 each. In H. R. Nickel or Aluminum ' ' 

Cases. At your dealer or postpaid on receipt of price. 45 VESEY STREET, NEW YORK. 



A Medical Defense Union 

which protects Physicians and 
Surgeons in Suits for 

[Civil Malpractice 




^ Literature by Mail. Fort Wayne, Indiana. 



are in successful use in all parts of the world. 

Direct medication with nebulized vapor is the 
most successful form of treatment for t>ulmonari| 
tuberculosis and all affections of the ear, nose, throat 
and lungs. 

GLOBE NEBULIZERS are the acknowledged 
standard the world over. Instruments and prices to 

suit all conditions. Write for circulars. 




RATES i^d^t^t^ 




Physicians wishing to 

Sell or 

can have notice inserted in space 1x2 3-4 inches for $1.00 an 
insertion, or six insertions for $5.00. If answers are to be sent 
to the office of the Detroit Medical Journal, add 25c. 




You May- 

WAMPOLE'S MILK FOOD for mother's milk without 
interfering with the baby's nutrition or digestion. 

There is nothing in it that is not found in Mother's 
Milk ; there is nothing in Mother's Milk that is not found 

MilK Food 

It is thoroughly cooked and ready for use by simply 
adding warm water. 

Furnished only in glass containers which are 
securely sealed. 

Samples cheerfully furnished without charge ; cor- 
respondence on the subject of artificial foods solicited, 
which will receive prompt and courteous attention. 

Made by 

Henrx K. IVampole (Si Co., 

Specialists in Progressive Pharmacy, 

Ori^nators and Sole Manufacturers of Wampole's Perfected 
and Tasteless Preparation of Cod Liver Oil. 

Main Office and Lalwratories. PHILADELPHIA, U.S.A. 



What Dr. Jacob! says a TRIE Infants' Food 
should be: 

1. "Without CCW'S MII^K, no substi- 
tute Infant Food can be thought of." 

2. "At present it begins to be considered fair 
to accept that milk becomes more digestible 
by the addition of FLOUR decoctions." 

3. "The identity of Milk Sugar in woman's 
and cow's milk is very doubtful, and the 
Milk Sugar of the market is quite often 
impure. That alone makes it desirable or 
advisable to substitute C A. N £ 

^. "Babies should frequently be offered 
WAXCR in some shape or other, and 
it is easiest to add it to their food." 


1. Pure CO"W'S MILK is the basis of 


2. Baked FLOUR, from selected wheat, 

with the starch converted into dextrim. 

3. Refined CANE SUGAR, sufficient 

to render it palatable. 

4. Prepared by the addition of "WATER 





Goodrich Sop Rubber Catheters 






A distinctive line of New Am- 
erican Soft Rubber Urethral 
Instruments, made of the best 
compound red rubber, with "that 
desirably soft velvety surface," 
and in accordance with the ad- 
vanced ideas of the surgical pro- 

Please ask for these goods. 


The B. f. Goodrich Coml^dDy, 



66-68 Reade St. 141 Lake Street. 67 Chauncey St. • 

SAN FRANCISCO, 308 Mission Street. • 


___ * 

!2i:^='Send for our booklet on Soft Rubber Catheters. 

.^^>f >f)f )f )f 3f )4-jf)f Jf Jf)f . 








LATION ::::::::::::: 

Write for Descriptive Circular and Price. 

Can be Readily Softened and 
Fitted to tHe Form writH tHe 
Utmost A.ccuracy-. yf yf if 




I Perfect Asepsis and 
I Antisepsis 

Something: New! 


Price 25c each; $2.00 per dozen. (One-Third Size.) 

Price 25c each; $2.50 per dozen. (One-Third Size.) 

Price 3SC each; $3.00 per dozen. (One-Third 5ize.) 

The first illustration represents our New Aseptic Dressing 
Syringe, provided with extra long nozzle, whereby it is possible 
to reach deep into wounds and abcesses for the purpose of cleansing 
and sterilizing the most remote parts thereof. 

Next follows an Aseptic, Cone-Pointed Gonorrhoea Syringe, the 
advantages of which are self- apparent. 

Lastly we call attention to the new, Aseptic Intra-Uterine 

Being of glass, with detachable rubber bulb, these syringes can 
be readily and thoroughly cleansed and disinfected: May be boiled if 

NOTE — The capacity of each syringe, from point to neck, is exactly that 
of the air capacity of the bulb, thereby preventing contact of the syringe-con- 
tents with the rubbers. 

The Only Instrument Suitable for Employment of 

Hydrogen Peroxide; Bicloride; Permanganate, Etc. 


No. 2 Richmond Street, East, a68 Woodward Avenue, * 








Metal Cases $3'7S 

Velvet Lined Cases 4 .00 


All GENUINE have our name on instrument. Buy from your dealer, or, if not in 
stock, from as direct 


Sole Agents for \J. S. A., PKiladelpHia. 


(Superior to the Xonsilotome. 

One end of the wire is anchored at "A" and the other wire fastened at "B." whereby the tonsil is made to rotate, inducing 
torsion of the vessels and practically no haemorrhage. 

Manufactured exclusively by 

Hand made, of tKe very best Steel. THE J. F. HARTZ CO., 

Price $0.00. net. 268 Woodward Ave., Detroit, mich. 

^ 2 Richmond St., East, TORONTO, ONT. 


In Hermetically Sealed Glass Tubes 

The price is 25cts. per tube, or $2.00 
per dozen, of any desired assortment. 

Mailed to any <uldress upon receipt of 

Our Sterilized Catgut and Kangaroo-Tendon are absolutely aseptic. This is assured by direct test 
of the bacteriological laboratory, and the strict adherence to bacteriological principles whichjprevail in 
our sterilizing laboratory. 

Kangaroo-Tendon and Catgut, plain and chromicized, in these glass tubes will always remain 
aseptic, and they are always ready for use. 

"Van Horn & Co.'s tendon and catgut sutures have been used by Dr. Bull and myself for 
nearly ten years, and frequent bacteriologrical tests have always shown them sterile." 

DR. W. B. COLEY, Annals of Surgery, Dec, 1900. 
1729 Chestnut St., Philadelphia. 
"I find your Kangaroo-Tendon the best on the market, and I now always use It." 

W. W. KEEN, Prof. Surgery, Jefferson Medical College. 


Sole Agents for Michigan and Ontario. 
268 Woodward Ave., DETROIT, MICH. 

2 Richmond St., TORONTO, ONT. 


Surgical Dressings, 

307 Madison Ave., NEW YORK. 





A Sanitary Necessity 


The Only One 
in its class: 

Nothing Else 
Like It. 



Nozzle made in one piece— hard rubber, highly polished. The detachable pneumatic 
cushion, of soft rubber, is a non-conductor of heat. Anatomically correct in design : Fits 
perfectly without undue pressure, and isn't a wedge. 

Dispenses with the inconvenient and troublesome bed-pan and rubber sheet. 

Not necessary to disrobe when douche is taken. 

Only syringe that can be employed in any position, without accessories, or an attendant. 

E. J. HUSSEY & CO., 

80 John Street, NEW YORK. 

The E. & G. Improved Atomizers. 

The B.T. H. No. 456 Physicians' Atomizers. 

Jfll Jill Jill 


ft 1 

Bi 1 



These Physicians' Sets are made with the greatest care in every detail, and finished in the 
best possible manner. The tips are our well known B. T. H. style and are platinum lined. 

For Sale by all Surgical Instrument Dealers and Physicians' Supply Houses. 






Medical and Surgical Plasters 

• Absorbent Cottons 

Surgical Dressings, Suspensories 

Chest Protectors 

g^flPi^Etc, Etc, 

283 25th St., Chicago. 



Pink Cathartic 


Are most popular with the medical profession. 

Act physiologically by increasing Peristalsis, stimulating se- 
cretions of Liver, and Pancreas, as well as the glands generally 
throughout the Intestinal tract ! 

Each Granule contains : — 

Aloin, C. P., - - - 1-6 grain. 

Podophyllin resin, - - Va grain. 

Extract Nux Vomica, - - % grain. 

Extract Belladonna Lvs., - % grain. 

Dose. — One to Two or Three as re- 

Are available whenever an Aperient, Laxative or Cathartic, 
pure and simple, is indicated; 

Are adapted to the needs of the young or the old ; for the most 
delicate and the most robust alike. 

When discontinued do not leave the patient in a more consti- 
pated condition than when begun. 

Put up in bottles of 1,000 and 5,000 each. 

Price, .50 per 1,000 
Price, $2.25 per 5.000 

Note. — We are the sole authorized purveyors of the Milbum 


2O8 ■WToodwara Avenue, DETROIT, MICH. . 

No. 2 R.icHinond Street, TOR.ONTO, ONT. i 



The Lakeland Hospital 




I^ O C A T E D 

OverlooKis\|f t H e 
beautiful sceners' 
of I^aKe St. Clair. 



Detroit, Mich. 

In Charge of Dr. Samuel Bell, formerly 
Medical Superintendent of the Upper 
Peninsula Hospital for Ihe Insane. 


(Seventh Revised Edition) 

Will appear in due time. Send 
for descriptive circulars. Physi- 
cians who have moved since 
1898 should notify the publish- 
ers promptly. 

Polk's Medical Directory has 
been established 15 years. Do 
not be deceived by untried and 
unknown Imitations. 

I R. L. POLK & CO., Publishers, 
I DETROIT, men. 


I •«•"•"...•-•...- 

~....~.«....»«-.-.~."....~«~.~»~»~« I 

An Even 


will buy a 




The most reliable, accurately built, complete, 
and desirable microscope ever oflfered for $100.00. 
Meets every requirement for Bacteriology, His- 
tology, Pathology, Biology, Urinary 'Work, Etc. 
Two eyepieces ij and J dry and j". Oil Immersion 
Lenses, Abbe Condenser and Iris Diaphragm, 
and Triple Revolving Nosepiece. Usecl at Cor- 
nell, Harvard, Yale, University of Chicago, Col- 
lege of P. and S., and scores of other prominent 


MfrHe for Cub Dlnronnt. 


New York. ROCHESTER, N. Y. Chicago. 



Tablets and Pills 

Tablet Trittirates 
Tablets Compressed 
Tablets and Pills, *«%Sated 
Tablets and Pills, ^'^^fo^ifeS 

Full lines of all standard formulas in packages of 1 00 ; 
500; 1000, or in bulk. Our own production — "Made on 
Honor ! " 

Special formulas to order — Our Specialty! 

If Honest Goods, 

TKe Best Quality in Drti^s, 

A.ncl the A,cnie in FinisK. 

is desired, it will pay you to seek prices at our hands. 

If cheap goods, unreliable drugs, and fake formulas are 
demanded, do not apply to us. 

carried in stocK. j^ j0 j0 j0 jE/ 

the: j. f. hartz company, 

268 -Woodward A.-venue, DETROIT, MICH. 

No. 2 R.icHmond Street, TOR.ONTO, ONT. 



• •• x^HE^*** 

No. I. 

SpHnt Qate 



No. a. 


These are so obviously SUPERIOR and SENSIBLE, they can not but ap- 
peal to every progressive practitioner at a glance. 

Made of aluminum, they may be rendered sterile and will not rust; are 
moreover light and inexpensive. 

They enclose but do not touch the wound; dressing can thus be attended 
AD LIBITUM and without pain. 

A wound covered by the gate 
(which being concave-convex, 
has great strength) has a positive 
protection from chafing or injury. 
Opened with ease, it permits of 
instant examination. 

No. 3- 

No. 4. 

Figure i and 2 represents our Vaccine and Boil Cap: Made in three 

Figure 3 and 4 reveal our Splint Gate : Made in two sizes, and may be 
easily and quickly attached to any splint, or plaster cast. 

Figure 5 and 6 show our Finger Splint Cot, equally applicable to hands 
or feet: Made in three sizes. 


Splint Qate & 
Bandage Co., 


No. 5- 

No. 6. 

r^ Mi, ■ 


The only reliable lotion for the prompt and 
effectual eradication of Acne in all 
its protean forms— Guaranteed I 

(formula of g. r, shimmbl.) 

This preparation represents the greatest possible therapeutic 
activity, along with the perfection of pharmaceutical art and chemical 
skiir In pint bottles only. 


Price: 75 Cents per Bottlb, Net. 


Price: 50 Cents Each. 

A Hartz combined Acne Lance and Comedo Extractor will be presented to 
every physician with his first order for Albasulphidi, thus making his equipment 
complete as regards the management of this most stubborn of skin maladies 

N. B. As this offer is made only to introduce Albasulphidi, the instrument 
cannot be supplied gratis to more than one individual, and only to a physician. 


268 Woodward Ave., Detroit, Mich. 
No. 2, East Richmond St., Toronto, Ont. 

Price, $1.50 per i.uoo. 

75c per 500. 





Cannabln 1-10 grain 

Zinc Pliospliide 1-10 grain 

Strych. Phos 1-40 grain 

Avenine 1-200 grain 

Anodyne, Antispasmodic, Aphrodisiac, 
Hypnotic, Nervine, Reconstructive, Roborant, 

A true Anodyne and Sedative to the 
stomach without any of the inconveniences 
attending the uses of Chloral, Bromides or 

Promotes assimilation, msiead of retarding. 

Unequalled in the management of funct- 
ional dyspepsias. 

Acts like magic in relieving the pains of 
Rheumatism and Gout, is an almost specific in 
most forms of Neuralgi?. 

Confederation Life Building. 
Toronto, Ontario. 

268 Woodward Ave., 
Detroit, Mich. 


The J. F. Hartz Co., |